NPIMap

Organization Active NPI

Jeffrey P Alexander DDS a Dental Corp

  • General Practice Dentistry
  • Oakland, CA
National Provider Identifier
1801959515
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
26327 Issued in CA
Legal business name
JEFFREY P ALEXANDER DDS A DENTAL CORP
Doing business as
Youthful Tooth
Practice address
8201 Edgewater Dr
Suite 105 &106
Oakland, CA 94621
Phone
(510) 568-3577
Fax
(510) 568-8178
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Authorized official

Name
Jeffrey Alexander, DDSNPI 1184804908
Title
Owner
Phone
(510) 568-3577

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 26327 CA Primary

Addresses

Primary practice location

8201 Edgewater Dr
Suite 105 &106
Oakland, CA 94621

Mailing address

PO Box 14266
Oakland, CA 94614
Phone (510) 568-3577

Other identifiers 1

IdentifierTypeStateIssuer
G93765MedicaidCA

Other names 1

  • Youthful Tooth Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jeffrey P Alexander DDS a Dental Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8201 Edgewater Dr
Ste 105
Oakland, CA 94621
Phone (510) 568-3577

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1801959515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14266",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94614",
            "telephone_number": "510-568-3577",
            "fax_number": "510-568-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 EDGEWATER DR",
            "address_2": "SUITE 105 &106",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94621",
            "telephone_number": "510-568-3577",
            "fax_number": "510-568-8178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY P ALEXANDER DDS A DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-568-3577",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "26327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G93765",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Youthful Tooth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.