Jeremiah J Parker, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

7025150-9921 Issued in UT

Practice address

10TH Medical Group
4102 Pinion Drive
Usaf Academy, CO 80132

Phone

(571) 275-8412

NPI assigned

May 28, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1972761765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18620 KNOLLWOOD BLVD",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801328970",
            "telephone_number": "571-275-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10TH MEDICAL GROUP",
            "address_2": "4102 PINION DRIVE",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "80132",
            "telephone_number": "571-275-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JEREMIAH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2023-11-01",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "7025150-9921",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "7025150-9921",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lesa Ellen Owens, WHNP
• Karem Pabon-Rodriguez, LPCC
• Gregory Palmrose, PHARMD
• Christine Dohyun Park
• Edward Parker, O.D.
• Sarah Parsch, DMD
• Lisa Beth Paulson, PA-C
• Thomas Gerhard Pelkmann, MD
• Jason Petrash
• Ashley Z Pierce, ATC, CSCS

• Endodontics in Usaf Academy, CO
• Providers in Usaf Academy, CO by specialty
• Endodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.