Jeffrey S Gifford, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3440 Issued in AZ

Practice address

112 Sixth Ave
Page, AZ 86040

Phone

(928) 645-3206

Fax

(928) 645-9139

NPI assigned

Aug 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Page Dental Center

  • General Practice Dentistry
  • Page, AZ
  • NPI 1164689139
  NPD (past) Authorized official

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871601625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1956",
            "address_2": "112 SIXTH AVE",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "86040",
            "telephone_number": "928-645-3206",
            "fax_number": "928-645-9139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 SIXTH AVE",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "86040",
            "telephone_number": "928-645-3206",
            "fax_number": "928-645-9139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIFFORD",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D3440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "086274",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Jamaica Fat Denatsosie, FNP-C
• Niove N Fatule
• Dennis James Foley, MD
• Peggy Fuhrman, MASTERS EDUCATION
• Mark Ernst Giesecke, MD
• Todd Glasenapp
• Krishna Chaitanya Gondi
• Michele P Grim, R.D.
• Maureen V. Guilfoyle, LICSW
• John R Harlan, MD

• General Practice Dentistry in Page, AZ
• Providers in Page, AZ by specialty
• General Practice Dentistry in Arizona

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.