Provider Demographics
NPI:1699909978
Name:ALFORD, JEFFREY ANDREW (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ANDREW
Last Name:ALFORD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 LOHMANS CROSSING
Mailing Address - Street 2:SUITE 208
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734
Mailing Address - Country:US
Mailing Address - Phone:512-261-6900
Mailing Address - Fax:512-532-0303
Practice Address - Street 1:1921 LOHMANS CROSSING
Practice Address - Street 2:SUITE 208
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734
Practice Address - Country:US
Practice Address - Phone:512-261-6900
Practice Address - Fax:817-416-0700
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212791223S0112X
TX00212791223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2120958Medicaid