Basic Information
| Provider Information | |||||||||
| NPI: | 1578710331 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JEPPSON | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6950 NE CAMPUS WAY | ||||||||
| Address2: | |||||||||
| City: | HILLSBORO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5039522503 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9019 E MISSION AVE | ||||||||
| Address2: | |||||||||
| City: | SPOKANE VALLEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992122534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8554336825 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2008 | ||||||||
| LastUpdateDate: | 10/26/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | D-4167 | ID | N | Dental Providers | Dentist | 122300000X | DS037626 | PA | N | Dental Providers | Dentist | 1223E0200X | 8121225-9922 | UT | N | Dental Providers | Dentist | Endodontics | 1223E0200X | 8121225-9921 | UT | N | Dental Providers | Dentist | Endodontics | 1223E0200X | D0934 | SD | N | Dental Providers | Dentist | Endodontics | 1223E0200X | D-4167-EN | ID | Y | Dental Providers | Dentist | Endodontics |
No ID Information.