Jefferson, Jay Alan

Jefferson, Jay Alan is an individual health care provider with primary practice located at 8301 Bandford Way Suite 121, Raleigh NC 27615-2767. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Jefferson, Jay Alan can be contacted via phone (919) 876-4746.

Contact Information

Primary practice address
8301 Bandford Way Suite 121 Raleigh NC 27615-2767
Phone: (919) 876-4746
Fax: (919) 876-5071
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 5669 North Carolina

Profile Details

NPI number 1063471431
LBN Legal business name Jefferson, Jay Alan
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2006
Last updated Jul 16th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063471431 NPPES
Other 94549 BCBS
MEDICAID 8994549 BCBS

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