JADA ROBERTS (NPI# 1588072045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588072045 |
| Entity Type | Individual |
| Full Name | JADA ROBERTS |
| Practice Address |
2828 E State Blvd Suite B Fort Wayne IN 46805-4761 |
| Practice Telephone | 2604826689 |
| Practice Fax Number | 2604826948 |
| Mailing Telephone | 2604826689 |
| Mailing Fax Number | 2604826948 |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2014-07-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 12012082A | IN | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154983146 | Jada Nicole Roberts | Genetic Counselor, MS | 1200 Childrens Ave Ste 12100, Oklahoma City, OK 73104-4637 | 2019-07-01 |
| Street Address |
2828 E STATE BLVD SUITE B |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-4761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700871118 | Chad Stoller | Dentist | 2828 E State Blvd, Fort Wayne, IN 46805-4761 | 2005-09-13 |
| 1083167498 | Noopur Patel | Dentist | 2828 E State Blvd, Suite A, Fort Wayne, IN 46805-4761 | 2016-08-02 |
| 1306094354 | Nkechi A Wan | Dentist | 2828 E State Blvd, Suite B, Fort Wayne, IN 46805-4761 | 2008-09-03 |
| 1336361740 | Lifetime Dental Care of Indiana, PC | Dentist | 2828 E State Blvd, Fort Wayne, IN 46805-4761 | 2007-05-03 |
| 1780800243 | Mathew Kavanaugh | Dentist | 2828 E State Blvd, Suite B, Fort Wayne, IN 46805-4761 | 2007-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| 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 |
|---|---|---|---|---|
| 1669025037 | Emma Kathleen O'heeney | Dentist | 9405 Illinois Rd, Fort Wayne, IN 46804-5795 | 2019-07-24 |
| 1023670874 | Cory Kappesser | Dentist | 10505 Lima Rd, Fort Wayne, IN 46818-9536 | 2019-07-02 |
| 1558843698 | John Lawrence Bixler | Dentist | 7207 Engle Rd Ste 2, Fort Wayne, IN 46804-2231 | 2018-09-05 |
| 1366960445 | Chelsea L Schafer | Dentist | 2828 E State Blvd Ste A, Fort Wayne, IN 46805-4761 | 2017-09-08 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1740697945 | Vishali Sharma | Dentist | 4716 Illinois Rd, Fort Wayne, IN 46804-5122 | 2014-07-20 |
| 1306250642 | Jeffrey Max Batesole | Dentist | 9121 Illinois Rd, Fort Wayne, IN 46804-5753 | 2014-06-15 |
| 1891120382 | Salkeld Family Dental, LLC | Dentist | 12962 Coldwater Rd, Fort Wayne, IN 46845-9517 | 2013-09-04 |
| 1205272168 | Tyler Jerome Kimmel | Dentist | 1717 S. Calhoun Street, Fort Wayne, IN 46802 | 2013-05-20 |
| 1467726851 | Gentle Care Family Dentistry | Dentist | 2444 Getz Rd, Fort Wayne, IN 46804-1632 | 2012-03-02 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
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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.