NPIMap

Organization Active NPI

Jeffrey P Alexander DDS a Dental Corp

  • General Practice Dentistry
  • Pinole, CA
National Provider Identifier
1982770988
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
26327 Issued in CA
Legal business name
JEFFREY P ALEXANDER DDS A DENTAL CORP
Doing business as
Youthful Tooth
Practice address
2762 Pinole Valley Rd.
Pinole, CA 94564
Phone
(510) 758-6684
Fax
(510) 669-2083
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Authorized official

Name
Jeffrey Alexander, DDS
Title
Owner
Phone
(510) 568-3577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 26327 CA Primary

Addresses

Primary practice location

2762 Pinole Valley Rd.
Pinole, CA 94564

Mailing address

2762 Pinole Valley Rd.
Pinole, CA 94564
Phone (510) 758-6684

Other identifiers 1

IdentifierTypeStateIssuer
G93765MedicaidCA

Other names 1

  • Youthful Tooth Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jeffrey P Alexander DDS a Dental Corp2 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580774400000",
    "number": "1982770988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2762 PINOLE VALLEY RD.",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "94564",
            "telephone_number": "510-758-6684",
            "fax_number": "510-669-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2762 PINOLE VALLEY RD.",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "94564",
            "telephone_number": "510-758-6684",
            "fax_number": "510-669-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY P ALEXANDER DDS A DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-568-3577",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "26327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G93765",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Youthful Tooth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Youthful Tooth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pinole, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; 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.