Healthcare Provider Details

I. General information

NPI: 1447039813
Provider Name (Legal Business Name): JEFF CASEBIER DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RIDGE VIEW DR STE 100
CARY NC
27511-5589
US

IV. Provider business mailing address

551 ABBEY FIELDS LOOP
MORRISVILLE NC
27560-5548
US

V. Phone/Fax

Practice location:
  • Phone: 919-481-0330
  • Fax:
Mailing address:
  • Phone: 808-343-4254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFF CASEBIER
Title or Position: OWNER
Credential: DMD
Phone: 808-343-4254