DR. JACK ANDREW NELSON (NPI# 1629166590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629166590 |
| Entity Type | Individual |
| Full Name | DR. JACK ANDREW NELSON |
| Credential | OMFS |
| Practice Address |
240 W Montauk Hwy Hampton Bays NY 11946-3510 |
| Practice Telephone | 6317281300 |
| Practice Fax Number | 6317285165 |
| Mailing Telephone | 6317281300 |
| Mailing Fax Number | 6317285165 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2016-03-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
0429341 | NY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01548470 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992096754 | Jack Nelson | Psychologist | 2219 Laurel Ln, Allison Park, PA 15101-2103 | 2011-04-28 |
| 1659545879 | Jack Orrin Nelson | Physical Therapist | 19 W Newton St, Rice Lake, WI 54868-1744 | 2008-04-18 |
| 1114140159 | Jack Nelson | Adult Companion | 9 Hanover St, Suite 2, Lebanon, NH 03766-1312 | 2007-04-10 |
| Street Address |
240 W MONTAUK HWY |
| City | HAMPTON BAYS |
| State | NY |
| Zip Code | 11946-3510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619943875 | Gabriel R Ariola | Emergency Medicine | 240 W Montauk Hwy, Hampton Bays, NY 11946-3510 | 2006-02-27 |
| 1013225887 | East End Oral Surgery | Dentist | 240 W Montauk Hwy, Hampton Bays, NY 11946-3510 | 2010-09-15 |
| 1891984548 | Kennworth Eaton II | Physician Assistant | 240 W Montauk Hwy, Hampton Bays, NY 11946-3510 | 2007-10-18 |
| 1770531220 | Prime Care Medical of Long Island, PC | Family Medicine | 240 W Montauk Hwy, Hampton Bays, NY 11946-3510 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093349029 | Martha Danielle Belesis | Social Worker | 6 East Canal Ct, Hampton Bays, NY 11946 | 2020-02-28 |
| 1568005270 | Robert Joseph Whelan | Massage Therapist | 1 Roberta Court, Hampton Bays, NY 11946 | 2019-10-25 |
| 1912569286 | Patrick P Reilly | Physical Therapy Assistant | 51 Fanning Ave, Hampton Bays, NY 11946 | 2019-07-08 |
| 1376073908 | Town of Southampton | Clinic/Center | 25 Ponquogue Ave, Hampton Bays, NY 11946 | 2017-06-15 |
| 1932647229 | Deena Lippman | Registered Nurse | 7 Debbie Trail, Hampton Bays, NY 11946 | 2017-02-07 |
| 1285176768 | Brian Jake Meringola | Physical Therapist | 13 Higbee Road, Hampton Bays, NY 11946 | 2016-11-15 |
| 1023564390 | Rehan Khalik | Pharmacist | 50 E Montauk Highway, Hampton Bays, NY 11946 | 2016-08-28 |
| 1164822680 | Robert Eugene Miller | Surgery | 1 Peconic Overlook, Hampton Bays, NY 11946 | 2014-09-03 |
| 1255674214 | Lynden Ishmael Watson | Nurse's Aide | 32 Lamplight Cir, Hampton Bays, NY 11946 | 2013-03-28 |
| 1073866570 | Barbara Jeanne Bendowski | Nurse Practitioner | 145 West Montauk Highway, Hampton Bays, NY 11946 | 2012-10-22 |
| Find all providers in zip 11946 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013225887 | East End Oral Surgery | Dentist | 240 W Montauk Hwy, Hampton Bays, NY 11946-3510 | 2010-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053921643 | Upper West Side Oral & Maxillofacial Surgery | Dentist | 140 W 69th St Ph 1g, New York, NY 10023-5173 | 2020-08-07 |
| 1467092965 | Nyc Implant and Oral Surgery PC | Dentist | 30 E 60th St Ste 907, New York, NY 10022-1058 | 2020-01-13 |
| 1235777566 | Asnis Dental Pllc | Dentist | 800 Woodbury Rd Ste C, Woodbury, NY 11797-2503 | 2019-12-17 |
| 1700420429 | Chavkin Oral and Maxillofacial Surgery LLC | Dentist | 414 Jericho Tpke Ste 2, New Hyde Park, NY 11040-4510 | 2019-11-06 |
| 1730737545 | Southwoods Boulevard Dental, P.C. | Dentist | 7 Southwoods Blvd Ste 1, Albany, NY 12211-2526 | 2019-08-27 |
| 1750947792 | Eduard Munarov Dds PC | Dentist | 449 N State Rd Ste 102, Briarcliff Manor, NY 10510-1478 | 2019-05-15 |
| 1598227530 | Asnis Dental Pllc | Dentist | 250 Patchogue Yaphank Rd Ste 10, East Patchogue, NY 11772-4862 | 2019-04-01 |
| 1720545387 | Asnis Dental, Pllc | Dentist | 260 Middle Country Rd Ste 12, Selden, NY 11784-2570 | 2019-03-01 |
| 1205344819 | Ray Cheng Dds | Dentist | 217 Park Row Ste 4b, New York, NY 10038-1101 | 2018-01-17 |
| 1871006064 | Ny Oral and Maxillofacial Surgeon, PC | Dentist | 2844 Ocean Pkwy Ste B2, Brooklyn, NY 11235-7904 | 2017-11-09 |
| Find all providers with the same taxonomy | ||||
| City | HAMPTON BAYS |
| Zip Code | 11946 |
Please comment or provide details below to improve the information on DR. JACK ANDREW NELSON.
| 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.