Jeffrey David Weaver, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4099 Issued in SC

Practice address

25 Innovation Dr
Greenville, SC 29607-5252

Phone

(864) 210-9075

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• McKnight & Weaver, LLC

  • General Practice Dentistry
  • Port Royal, SC
  • NPI 1366643546
  NPD (past) Authorized official
• Riccobene & Associates CCC, DDS, PC

  • General Practice Dentistry
  • Greenville, SC
  • NPI 1336025097
  NPD

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1801949334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 EDGE CT UNIT C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296095576",
            "telephone_number": "843-597-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 INNOVATION DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075252",
            "telephone_number": "864-210-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Epps Weatherly
• Tyler Weathers
• Angelica Weaver
• April Nicole Weaver
• David E. Weaver, O.D.
• Maria Weaver, MS, OTR/L
• Abby Rebecca Lay Webb, PA-C
• Casey Webb
• Colin B Webb, MD
• Katelyn Marcie Webb, APRN, FNP-C

• General Practice Dentistry in Greenville, SC
• Providers in Greenville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.