MEDICARE: DR. JASON RYAN ESTEP D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3549-10	MS

General Provider Information

NPI Number	:	1699086751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON RYAN ESTEP D.M.D.

Provider Business Mailing Address
First Line	:	PO BOX 73
Second Line	:
City	:	POPLARVILLE
State	:	MS
Zip	:	39470-0073
Country	:	US
Telephone Number	:	601-795-8024
Fax Number	:

Provider Business Practice Location Address
First Line	:	2113 GOVERNMENT ST
Second Line	:	STE K1
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3954
Country	:	US
Telephone Number	:	228-806-5710
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2010
Last Update Date	:	03/12/2025

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