Humberson, Jeffrey Wade
Humberson, Jeffrey Wade is an individual health care provider with primary practice located at 490B W Zia Rd , Santa Fe NM 87505-7008. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Humberson, Jeffrey Wade can be contacted via phone (505) 428-7878.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | DEN.00203125 | Colorado |
| Dental Providers / Pediatric Dentistry | 1223P0221X | 11810 | Maryland |
| Dental Providers / Pediatric Dentistry | 1223P0221X | DD2156 | New Mexico |
Profile Details
| NPI number | 1487642641 |
|---|---|
| LBN Legal business name | Humberson, Jeffrey Wade |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2005 |
| Last updated | Feb 13th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487642641 | NPPES |
| New Mexico | MEDICAID | 000A9157 |
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