Jefferson Lamar Newbern III, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

GA9459 Issued in GA

Practice address

800 Northwood Park Dr
Valdosta, GA 31602-1392

Phone

(229) 242-6202

Fax

(229) 245-0155

NPI assigned

Apr 1, 2008

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

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 and National Provider Directory roles.

• Newbern & Newbern, LLP

  • Dental Clinic/Center
  • Valdosta, GA
  • NPI 1649444399
  NPD (past) Authorized official

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1992977631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 NORTHWOOD PARK DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021392",
            "telephone_number": "229-242-6202",
            "fax_number": "229-245-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 NORTHWOOD PARK DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021392",
            "telephone_number": "229-242-6202",
            "fax_number": "229-245-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERN",
        "first_name": "JEFFERSON",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "GA9459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nemps of Georgia LLC
• Nes of Shelby Inc
• Neurology, Neurosurgery, and Spine Clinic of South Georgia
• Newbern & Newbern, LLP
• Brenda Newbern
• Stacie Newbern
• Maria Newham
• Steven Keith Newsom, RPH
• Stacey Newsome
• Denah Newton, NP

• Pediatric Dentistry in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.