NPIMap

Organization Active NPI

Jack D Griffin Jr DMD PC

  • Dentist
  • Eureka, MO
National Provider Identifier
1831291277
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
014900 Issued in MO
Legal business name
JACK D GRIFFIN JR DMD PC
Practice address
18 Hilltop Village Center Dr
Eureka, MO 63025-3921
Phone
(636) 938-6241
Fax
(636) 938-7941
NPI assigned
Sep 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Authorized official

Name
Jack Dean Griffin Jr., DMD PC FAGDNPI 1558457903
Title
Owner
Phone
(636) 938-6241

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
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 014900 MO Primary

Addresses

Primary practice location

18 Hilltop Village Center Dr
Eureka, MO 63025-3921

Mailing address

18 Hilltop Village Center Dr
Eureka, MO 63025
Phone (636) 938-6241

Other names 1

  • Eureka Smile Center Doing business as

National Provider Directory

National Provider Directory

Locations

18 Hilltop Village Center Dr
Eureka, MO 63025
Phone (636) 938-6241

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": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473120000000",
    "number": "1831291277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 HILLTOP VILLAGE CENTER DR",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "63025",
            "telephone_number": "636-938-6241",
            "fax_number": "636-938-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 HILLTOP VILLAGE CENTER DR",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630253921",
            "telephone_number": "636-938-6241",
            "fax_number": "636-938-7941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK D GRIFFIN JR DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2016-09-06",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-938-6241",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD PC FAGD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "014900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eureka Smile Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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.