Organization Active NPI

Jebediah S Christy DDS - Statesboro PLLC

  • General Practice Dentistry
  • Statesboro, GA
National Provider Identifier
1801353370
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JEBEDIAH S CHRISTY DDS - STATESBORO PLLC
Practice address
412 Northside Dr E
Statesboro, GA 30458-4802
Phone
(912) 225-0777
NPI assigned
Feb 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jebediah Christy
Title
Owner
Phone
(912) 225-0777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

412 Northside Dr E
Statesboro, GA 30458-4802

Mailing address

PO Box 70887
Cleveland, OH 44190-0887

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1801353370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70887",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441900887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 NORTHSIDE DR E",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584802",
            "telephone_number": "912-225-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEBEDIAH S CHRISTY DDS - STATESBORO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-21",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "CHRISTY",
        "authorized_official_first_name": "JEBEDIAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-225-0777"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.