DR. JERRY L HANEY (NPI# 1609863646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609863646 |
| Entity Type | Individual |
| Full Name | DR. JERRY L HANEY |
| Credential | DDS |
| Practice Address |
404 N 4th St Odessa MO 64076-1152 |
| Practice Telephone | 8166335393 |
| Practice Fax Number | 8166335395 |
| Mailing Telephone | 8166335393 |
| Mailing Fax Number | 8166335395 |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 13680 | MO | Dental Providers |
| Street Address |
404 N 4TH ST |
| City | ODESSA |
| State | MO |
| Zip Code | 64076-1152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548823966 | Bethany Jeanette Foss | Nurse Practitioner | 1280 W 40 Hwy, Odessa, MO 64076 | 2019-04-22 |
| 1619216231 | Heather N Begemann | Nurse Practitioner | 1280 West 40 Hwy, Odessa, MO 64076 | 2013-02-01 |
| 1558640334 | Linda Lou Proctor | Registered Nurse | 1278 Old Us 40 Hwy, Odessa, MO 64076 | 2011-08-10 |
| 1730499104 | Pamela Joyce Miller | Counselor | 406 A N. 4th Street, Odessa, MO 64076 | 2010-10-19 |
| 1225004781 | Richard Joseph Humble | Counselor | 406a N 4th, Odessa, MO 64076 | 2006-02-24 |
| 1568962611 | Tina Marie Davis | Nurse Practitioner | 1280 West 40 Hwy, Odessa, MO 64076 | 2018-02-15 |
| 1740701697 | Leslie Gleason | Counselor | 1278 W Us Highway 40, Odessa, MO 64076 | 2017-06-30 |
| 1982080008 | Danielle Fera | Counselor | 1278 W Us Highway 40, Odessa, MO 64076 | 2015-07-31 |
| 1184979940 | Lucas Paul Taylor | Counselor | 1278 W Us Highway 40, Odessa, MO 64076 | 2012-07-18 |
| 1093893893 | Missouri Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 101 S 2nd St, Odessa, MO 64076 | 2006-11-01 |
| Find all providers in zip 64076 | ||||
| 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 |
|---|---|---|---|---|
| 1902421381 | Samir Barsoum | Dentist | 2638 Gunn Hwy, Odessa, FL 33556-2541 | 2020-06-11 |
| 1982256798 | Winwood Dental and Orthodontics Pllc | Dentist | 3913 E 42nd Street, Odessa, TX 79762 | 2019-07-11 |
| 1831683168 | Gregg Liedtka Dmd Pllc | Dentist | 20 W 1st Ave, Odessa, WA 99159 | 2018-06-20 |
| 1295229722 | Daniel Darius Johnson | Dentist | 6109 E Highway 191, Odessa, TX 79762-5348 | 2018-06-18 |
| 1356899116 | Brittany Nalley | Dentist | 12456 State Road 54, Odessa, FL 33556-3477 | 2016-09-21 |
| 1588112338 | East Odessa Dental and Orthodontics Pllc | Dentist | 4901 E 42nd St Spc B, Odessa, TX 79762-7241 | 2016-09-21 |
| 1215481866 | Stephen Weiss Boyles | Dentist | 3930 Tanglewood Ln, Odessa, TX 79762-7165 | 2016-08-12 |
| 1760835359 | Jeremy A. Denman | Dentist | 8151 Dorado Dr, Odessa, TX 79765-8533 | 2016-07-19 |
| 1275824880 | Chrissorne Rameau | Dentist | 4901 E 42nd St, Odessa, TX 79762-7241 | 2011-04-29 |
| 1801054044 | Odessa Mall Fdc Pa | Dentist | 4101 E 42nd, Ste B23, Odessa, TX 79762-7239 | 2008-05-23 |
| Find all providers in ODESSA | ||||
Please comment or provide details below to improve the information on DR. JERRY L HANEY.
| 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.