Provider Demographics
NPI:1942268081
Name:JAFFE, DONALD E (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:E
Last Name:JAFFE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 UNION ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-5020
Mailing Address - Country:US
Mailing Address - Phone:508-993-1728
Mailing Address - Fax:508-997-2127
Practice Address - Street 1:319 UNION ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-5020
Practice Address - Country:US
Practice Address - Phone:508-993-1728
Practice Address - Fax:508-997-2127
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10204122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA10204OtherDELTA DENTAL OF MA
RI85557OtherDELTA DENTAL OF R I
MA9786813Medicaid
MA0218677Medicaid
MAX03216JAOtherBLUE CROSSBLUE SHIELD