Individual provider Active NPI

Jeffrey Allen Pumper, D.D.S.

  • General Practice Dentistry
  • Maple Grove, MN
National Provider Identifier
1851703789
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D13364 Issued in MN
Practice address
9600 Upland LN N
Suite 200
Maple Grove, MN 55369-4494
Phone
(763) 416-0037
NPI assigned
May 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D13364 MN Primary

Addresses

Primary practice location

9600 Upland LN N
Suite 200
Maple Grove, MN 55369-4494

Mailing address

9600 Upland LN N
Suite 200
Maple Grove, MN 55369-4494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D13364MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
PDG, P.a. General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1851703789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 UPLAND LN N",
            "address_2": "SUITE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 UPLAND LN N",
            "address_2": "SUITE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694494",
            "telephone_number": "763-416-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUMPER",
        "first_name": "JEFFREY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-27",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.