JERRY SANDERS (NPI# 1568521755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568521755 |
Entity Type | Individual |
Full Name | JERRY SANDERS |
Credential | D.D.S. |
Practice Address |
1607 E Rainforest Dr Fayetteville AR 72703-5385 |
Practice Telephone | 4795820600 |
Practice Fax Number | 4794434630 |
Mailing Telephone | 4795820600 |
Mailing Fax Number | 4794434630 |
Enumeration Date | 2006-12-06 |
Last Update Date | 2013-12-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
3424 | AR | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | DELTA DENTAL | 3424 | 01 |
AR | 149537608 | 05 | |
AR | UCCI | 1400699 | 01 |
AR | BCBS | 5X368 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922179530 | Jerry Sanders | Chiropractor | 539 Passaic Ave, Clifton, NJ 07014-1211 | 2006-11-13 |
1588745251 | Jerry Earl Sanders | Obstetrics & Gynecology | 1600 Agawela Ave, Knoxville, TN 37919-8319 | 2006-10-18 |
1730263203 | Jerry Kent Sanders | Registered Nurse | 7200 Cathedral Rock Dr, Suite 210, Las Vegas, NV 89128-0438 | 2006-10-24 |
Street Address |
1607 E RAINFOREST DR |
City | FAYETTEVILLE |
State | AR |
Zip Code | 72703-5385 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154401057 | Triplett, Sanders, Tompkins, Smith Pediatric Dentistry | Dentist | 1607 E Rainforest Dr, Fayetteville, AR 72703-5385 | 2006-10-16 |
1740526060 | Valerie Q Rockacy | Dentist | 1607 E Rainforest Dr, Fayetteville, AR 72703-5385 | 2012-12-13 |
1497083471 | Leah Sarah Jennings | Dentist | 1607 E Rainforest Dr, Fayetteville, AR 72703-5385 | 2009-12-02 |
1467672972 | Jason Maschal Landers | Dentist | 1607 E Rainforest Dr, Fayetteville, AR 72703-5385 | 2007-04-26 |
1407915515 | William Tompkins | Dentist | 1607 E Rainforest Dr, Fayetteville, AR 72703-5385 | 2006-12-06 |
1447319561 | Courtney Smith | Dentist | 1607 E Rainforest Dr, Fayetteville, AR 72703-5385 | 2006-12-06 |
1407915531 | Tonya R Triplett | Dentist | 1607 E Rainforest Dr, Fayetteville, AR 72703-5385 | 2006-12-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
Find all providers in zip 72703 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366060618 | A Dental Home 4 Kidz | Dentist | 155 Carnegie Pl Ste 201, Fayetteville, GA 30214-3981 | 2020-07-13 |
1508334400 | Smile Shoppe Fayetteville Jeffrey D. Rhodes Dds Ms Pllc | Dentist | 3484 W Wedington Dr, Fayetteville, AR 72704-5730 | 2018-11-08 |
1134405848 | Eaglin Dental Group, Fayetteville | Dentist | 692 Glynn St N Ste S, Fayetteville, GA 30214-6705 | 2011-10-26 |
1689974362 | Karen Anne Green | Dentist | 1607 E Rainforest Rd, Fayetteville, AR 72703 | 2010-10-27 |
1083872915 | Shannitta Latrease Bridgers | Dentist | 1367 Walter Reed Rd, Suite 103, Fayetteville, NC 28304 | 2008-05-28 |
1346300209 | Pediatric Dentistry & Interceptive Orthodontics P.C. | Dentist | 8016 E Genesee St, Fayetteville, NY 13066-9692 | 2006-12-11 |
1710052279 | Warren Coleman Massey | Dentist | 3089 E Mission Blvd, Fayetteville, AR 72703-4385 | 2006-11-21 |
1154401057 | Triplett, Sanders, Tompkins, Smith Pediatric Dentistry | Dentist | 1607 E Rainforest Dr, Fayetteville, AR 72703-5385 | 2006-10-16 |
1255422424 | Fred B Dunkelberger | Dentist | 570 W Lanier Avenue, Bldg #2, Fayetteville, GA 30214 | 2006-09-27 |
1073537627 | Yvette Mcalister Stokes, Dds, Pa | Dentist | 1770 Metromedical Dr, Fayetteville, NC 28304-3861 | 2006-07-27 |
Find all providers in FAYETTEVILLE |
City | FAYETTEVILLE |
Zip Code | 72703 |
Please comment or provide details below to improve the information on JERRY SANDERS.
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.