Active NPI
Jeffrey Thomas Weber, DMD
- Orofacial Pain Dentistry
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orofacial Pain Dentistry
- License
- DDS108250
- Practice address
- 4900 W Sunset Blvd Ste 6D
Los Angeles, CA 90027-5814 - Phone
- (480) 444-8272
- NPI assigned
- Nov 15, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orofacial Pain Dentistry | 1223X2210X | DDS108250 | CA | Primary |
| Dentist | 122300000X | D009135 | AZ |
Addresses
Primary practice location
4900 W Sunset Blvd Ste 6D
Los Angeles, CA 90027-5814
Mailing address
426 S Sepulveda Blvd Apt 301
Los Angeles, CA 90049-3556
Phone (480) 444-8272
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS108250 | CA | MD | Orofacial Pain Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| North Country Healthcare, Inc. | Current | Accepting new patients | |
| North Country Healthcare, Inc. | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| North Country Healthcare, Inc. | Current | Accepting new patients | |
| Mesa Modern Dentistry, LLP | General Practice | Past | Accepting new patients |
Locations
2920 N 4th St
Flagstaff, AZ 86004
Phone (928) 213-6100
1501 S Yale St
Ste 252
Flagstaff, AZ 86001
Phone (928) 774-1811
620 Lee St
Winslow, AZ 86047
Phone (928) 288-8700
4900 W Sunset Blvd
Ste 6D
Los Angeles, CA 90027
Phone (480) 444-8272
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
Organizations & group practices 7
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Panorama City, CA
- NPI 1407888928
-
- Multi-Specialty Clinic/Center
- Flagstaff, AZ
- NPI 1073583472
-
- Multi-Specialty Clinic/Center
- Show Low, AZ
- NPI 1073740098
-
- Family Medicine Physician
- Flagstaff, AZ
- NPI 1619345675
-
dba Mesa Modern Dentistry
- General Practice Dentistry
- Mesa, AZ
- NPI 1477821460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729555200000",
"number": "1831563832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "426 S SEPULVEDA BLVD APT 301",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900493556",
"telephone_number": "480-444-8272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 W SUNSET BLVD STE 6D",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900275814",
"telephone_number": "480-444-8272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBER",
"first_name": "JEFFREY",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-15",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223X2210X",
"taxonomy_group": "",
"desc": "Dentist, Orofacial Pain",
"state": "CA",
"license": "DDS108250",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D009135",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4733 W Sunset Blvd",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900276021",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.