DR. JESSE ELLEDGE (NPI# 1285100776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285100776 |
| Entity Type | Individual |
| Full Name | DR. JESSE ELLEDGE |
| Credential | DDS |
| Practice Address |
Commanding Officer 2d Denbn/ndc Psc 20130 315 Mchugh Blvd Camp Lejeune NC 28542-0130 |
| Practice Telephone | 9104512208 |
| Practice Fax Number | 9104518036 |
| Mailing Telephone | 9104512208 |
| Mailing Fax Number | 9104518036 |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2018-10-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 102671 | CA | Dental Providers |
| Street Address |
COMMANDING OFFICER 2D DENBN/NDC PSC 20130 315 MCHUGH BLVD |
| City | CAMP LEJEUNE |
| State | NC |
| Zip Code | 28542-0130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619515343 | Joseph Michael Medina | Dentist | Commanding Officer 2d Denbn/ndc, Psc 20130 315 Mchugh Blvd, Camp Lejeune, NC 28542-0130 | 2019-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730794439 | Lauren Marie Barton | Dentist | H M Smith Blvd, Bldg Fc-308, Camp Lejeune, NC 28542 | 2020-09-10 |
| 1003444928 | Andres Martin Rodoni | Military Health Care Provider | 2nd Reconnaissance Battalion, Camp Lejune, NC 28542 | 2020-03-27 |
| 1699306670 | Dominick Ciampo | Military Health Care Provider | A66 Boat Basin Road, Camp Lejeune, NC 28542 | 2020-01-29 |
| 1881243525 | Alexander Thomas Rodgers | Military Health Care Provider | 2nd Raider Battalion, A66 Boat Basin Rd, Camp Lejeune, NC 28542 | 2019-09-05 |
| 1992352454 | Kirsten Janel Snow | Physician Assistant | Hm Smith Boulevard, Bldg Fc-308, Camp Lejeune, NC 28542 | 2019-08-20 |
| 1639735947 | Cody Robert Patton | Military Health Care Provider | 3rd Marine Raider Battalion, Bldg 614, Camp Lejeune, Nc, NC 28542 | 2019-05-13 |
| 1558832345 | Nathaniel Franklin Campbell | Military Health Care Provider | Rr 612 Everett Creek Rd, Camp Lejuene, Fpo, AE 28542 | 2018-12-06 |
| 1578032504 | Brendon Earl Dumas | Military Health Care Provider | Rr612 Everett Creek Road, Camp Lejeune, NC 28542 | 2018-11-20 |
| 1053896514 | Roy Atallah | Military Health Care Provider | 2nd Marine Raider Battalion, Camp Lejeune, NC 28542 | 2018-10-01 |
| 1316422975 | Zachary Thomas Monahan | General Practice | Hm Smith Boulevard Bldg Fc-308, Camp Lejeune, NC 28542 | 2018-09-30 |
| Find all providers in zip 28542 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730794439 | Lauren Marie Barton | Dentist | H M Smith Blvd, Bldg Fc-308, Camp Lejeune, NC 28542 | 2020-09-10 |
| 1295387538 | Jackson J Whitcomb | Dentist | Commanding Officer 2d Denbn/ndc Psc 20310, 315 Mcghugh Blvd, Camp Lejeune, NC 28542-0130 | 2019-07-16 |
| 1992357651 | Ryan Carter Wainwright | Dentist | Commanding Officer 2d Denbn/ndc Psc 20130, 315 Mchugh Blvd, Camp Lejeune, NC 28542-0130 | 2019-07-12 |
| 1295244911 | Amy Sara Maya | Dentist | Commanding Officer, 2d Denbn/ndc 315 Mchugh Blvd, Camp Lejeune, NC 28542-0130 | 2017-09-26 |
| 1083134480 | Joshua W. Johnson | Dentist | 315 Mchguh Blvd, Commanding Officer, 2d Denbn/ndc Psc 20130, Camp Lejeune, NC 28542 | 2017-06-27 |
| 1043687759 | Michael David Hoglund | Dentist | 315 Mchugh Blvd 2d Denbn/ndc Psc 20130, Commanding Officer, Camp Lejeune, NC 28542-0130 | 2015-08-28 |
| 1548660566 | Eli Nathan Lowry | Dentist | Psc 20130 315 Mchugh Blvd, Commanding Officer, 2d Denbn/ndc, Camp Lejeune, NC 28542-0130 | 2014-08-27 |
| 1215368527 | Chase Westhall Fetters | Dentist | Commanding Officer, 2d Denbn/ndc, Psc 20130, 315 Mchugh Blvd, Camp Lejeune, NC 28542-0130 | 2013-12-12 |
| 1518392000 | David Parent Burr | Dentist | 315 Mchugh Blvd Commanding Officer, 2d Denbn/ndc, Psc 20130, Camp Lejeune, NC 28542-0130 | 2013-09-04 |
| 1942546072 | Inga Marie Keithly | Dentist | 315 Mchugh Blvd, 2d Denbn/ndc, Psc Box 20130 Commanding Officer, Camp Lejeune, NC 28542-0130 | 2012-12-18 |
| Find all providers in CAMP LEJEUNE | ||||
| City | CAMP LEJEUNE |
| Zip Code | 28542 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.