NPIMap

Organization Active NPI

Jeremy D. Wood, D.M.D, PC

  • General Practice Dentistry
  • Vidalia, GA
National Provider Identifier
1942575832
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013906 Issued in GA
Legal business name
JEREMY D. WOOD, D.M.D, PC
Doing business as
Darby Dental Services
Practice address
310 Jackson St
Vidalia, GA 30474-4708
Phone
(912) 537-3377
Fax
(912) 538-7010
NPI assigned
Mar 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Authorized official

Name
Tracy Allen
Title
Dental Assistant
Phone
(912) 537-3377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN013906 GA Primary

Addresses

Primary practice location

310 Jackson St
Vidalia, GA 30474-4708

Mailing address

310 Jackson St
Vidalia, GA 30474-4708
Phone (912) 537-3377

Other names 1

  • Darby Dental Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Darby Dental Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1942575832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 JACKSON ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744708",
            "telephone_number": "912-537-3377",
            "fax_number": "912-538-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 JACKSON ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744708",
            "telephone_number": "912-537-3377",
            "fax_number": "912-538-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY D. WOOD, D.M.D, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "DENTAL ASSISTANT",
        "authorized_official_telephone_number": "912-537-3377"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Darby Dental Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.