Jack A Elder is a Dentist in Benicia, California. Jack A Elder practices all healthcare services and medical treatments related to Dentist. The NPI Number for Jack A Elder is 1164509832. The last update date is 2009-06-03.
Jack A Elder's current location address is 172 East D Street, Benicia, California. You can contact this provider via phone number 7077453820 and fax number 7077465196. The mailing address for Jack A Elder is 172 East D Street, Benicia, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack A Elder |
|---|---|
| Address | 172 East D Street, Benicia, California |
| Phone Number | 7077453820 |
| Fax Number | 7077465196 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1164509832 |
|---|---|
| Provider Enumeration Date | 2006-11-01 |
| Last Updated Date | 2009-06-03 |
Provider Mailing Address Detail
| Address | 172 East D Street |
|---|---|
| City | Benicia |
| State | California (CA) |
| Post Code | 945100954 |
| Phone Number | 7077453820 |
| Fax Number | 7077465196 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 55157 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identifier code assigned to Jack A Elder by the Centers for Medicare & Medicaid Services?
The Jack A Elder has been issued the NPI (National Provider Identifier) 1164509832 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Jack A Elder is located?
The Jack A Elder is situated at the following address: 172 East D Street, Benicia, CA, 945100954.
What is the Jack A Elder's area of specialization and corresponding taxonomy classification?
The Jack A Elder's specialty field is Dentist, and it falls under the taxonomy code 122300000X, which categorizes healthcare providers based on their specialties.
On what date did the Jack A Elder receive its 1164509832 assignment from the Centers for Medicare & Medicaid Services?
The Jack A Elder was assigned its 1164509832 by the Centers for Medicare & Medicaid Services on 2006-11-01.
As of what date was the information regarding Jack A Elder, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jack A Elder, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2009-06-03.
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