JEREMY EDWARDS DDS PLLC (NPI# 1730672510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730672510 |
| Entity Type | Organization |
| Organization Name | JEREMY EDWARDS DDS PLLC |
| Practice Address |
1004 Medical Park Blvd Edmond OK 73013-3025 |
| Mailing Address |
3000 United Founders Blvd Ste 237 Oklahoma City OK 73112-4334 |
| Practice Telephone | 4053488184 |
| Practice Fax Number | 4053485349 |
| Mailing Telephone | 4058487974 |
| Mailing Fax Number | 4058480033 |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |
| Authorized Official Name | THAO T. VO (CREDENTIALING DEPARTMENT) |
| Authorized Official Telephone | 4058487974 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
6586 | OK | Dental Providers |
| Street Address |
1004 MEDICAL PARK BLVD |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-3025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407863616 | Lawrence Scott Holmgren | Dentist | 1004 Medical Park Blvd, Edmond, OK 73013 | 2006-08-01 |
| 1598944290 | Edmond Oral and Maxillofacial Surgery | Dentist | 1004 Medical Park Blvd, Edmond, OK 73013-3025 | 2007-10-30 |
| 1881706471 | Robert Martin Lamb | Dentist | 1004 Medical Park Blvd, Edmond, OK 73013 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
| Find all providers in zip 73013 | ||||
| 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 |
|---|---|---|---|---|
| 1891981635 | C. Ken Templeton, P.C. | Dentist | 125 East 3rd St., Suite A, Edmond, OK 73034 | 2007-09-14 |
| 1194826966 | Gregory T. Tull | Dentist | 5509 Inverary Dr, Edmond, OK 73025-2722 | 2006-09-26 |
| 1073622189 | Christopher Kenny Templeton Iv | Dentist | 125 E 3rd St Ste A, Edmond, OK 73034-3822 | 2006-08-30 |
| 1407863616 | Lawrence Scott Holmgren | Dentist | 1004 Medical Park Blvd, Edmond, OK 73013 | 2006-08-01 |
| 1194716803 | Zeneida G Vasquez | Dentist | 1218 E 9th St, Suite 7, Edmond, OK 73034-5796 | 2005-11-02 |
| 1598944290 | Edmond Oral and Maxillofacial Surgery | Dentist | 1004 Medical Park Blvd, Edmond, OK 73013-3025 | 2007-10-30 |
| 1881706471 | Robert Martin Lamb | Dentist | 1004 Medical Park Blvd, Edmond, OK 73013 | 2006-08-31 |
| 1932190469 | Sam P Jones Iv | Dentist | 1218 E 9th St, Suite 7, Edmond, OK 73034-5796 | 2005-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801303888 | Wisdom Tooth Center, Pllc | Dentist | 2745 S I 35 Service Rd, Moore, OK 73160-2715 | 2017-12-29 |
| 1033560966 | Medical Consultant Services | Dentist | 3309 W Princeton St, Broken Arrow, OK 74012-9587 | 2016-06-22 |
| 1487019071 | Stonewood Hills Oral Maxillofacial Surgery, Inc. | Dentist | 425 Stone Wood Dr, Broken Arrow, OK 74012-1026 | 2015-12-23 |
| 1477927085 | Justin Pisano | Dentist | 429 Nw 11th St, Apt 6, Oklahoma City, OK 73103-3927 | 2015-11-19 |
| 1558776989 | Daniel Szalay | Dentist | 1201 N Stonewall Ave Ste 206, Oklahoma City, OK 73117-1214 | 2014-06-24 |
| 1558771170 | Yukon Maxillo-facial Surgery Center | Dentist | 404 S Mustang Rd, Yukon, OK 73099-6754 | 2014-05-05 |
| 1649690025 | Andrew Mcgarry | Dentist | 10900 Hefner Pointe Dr Ste 204, Oklahoma City, OK 73120 | 2014-04-23 |
| 1740572601 | Lauren Lunday | Dentist | 3617 W Gore Blvd Ste B, Lawton, OK 73505-6373 | 2011-05-11 |
| 1265735724 | Michael J. Gliddon Dba Live Oak Oral Surgery | Dentist | 1415 Nw 33rd St, Lawton, OK 73505-3806 | 2010-12-06 |
| 1023329901 | Armando Retana | Dentist | 7322 E 91st St, Tulsa, OK 74133-6016 | 2010-06-25 |
| Find all providers with the same taxonomy | ||||
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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.