Jeffrey Dean Fleagle, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

016745 Issued in OH

Practice address

124 N Front St
Saint Marys, OH 45885-2392

Phone

(419) 394-2413

Fax

(419) 394-0510

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

Yes

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 OH

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

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801994876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 N FRONT ST",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852392",
            "telephone_number": "419-394-2413",
            "fax_number": "419-394-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 N FRONT ST",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852392",
            "telephone_number": "419-394-2413",
            "fax_number": "419-394-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEAGLE",
        "first_name": "JEFFREY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "016745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kurt Lynden Eversman, LPN
• Gabriel Factora, M.D.
• Kendra Ferrall, LMT
• Hannah Marie Finamore
• Terry Lyn Fisher
• Foot and Ankle Centers of Ohio, Inc.
• Kami Lyn Fox, CNP
• Kenneth L Fox, MD
• Connie Lynn Friemering, M.A.CCC/SLP
• Claire Christine Gabel

• General Practice Dentistry in Saint Marys, OH
• Providers in Saint Marys, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.