DR. JESS W MIKESELL (NPI# 1841311024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841311024 |
| Entity Type | Individual |
| Full Name | DR. JESS W MIKESELL |
| Credential | DDS |
| Practice Address |
1024 Jonas Ave Centralia IL 62801 |
| Practice Telephone | 6185332107 |
| Mailing Telephone | 6185332107 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 122300000X | Dentist | 014683 | MO | Dental Providers |
| X | 1223G0001X |
Dentist Specialization: General Practice |
319 009068 01901 | IL | Dental Providers |
| X | 122300000X | Dentist | IL | Dental Providers |
| Street Address |
1024 JONAS AVE |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| 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 |
|---|---|---|---|---|
| 1003117946 | Mikhai C. Ta, Dds, Ps | Dentist | 1211 S Gold St, Centralia, WA 98531-3715 | 2010-11-09 |
| 1174791990 | Samuel M Smith Dmd Phd PC | Dentist | 1519 East Mccord St, Centralia, IL 62801 | 2008-02-14 |
| 1528265725 | Paulus E Lawson Jr. | Dentist | 120 North Allen Street, Centralia, MO 65240 | 2007-06-29 |
| 1598972283 | Richard Phillip Logullo | Dentist | 1948 E Mccord St, Centralia, IL 62801 | 2007-05-16 |
| 1952516593 | Kerry M Oconnor | Dentist | 2401 Borst Ave, Centralia, WA 98531 | 2007-05-14 |
| 1659591790 | Eugene S Clarke | Dentist | 516 South Locust, Centralia, IL 62801 | 2007-04-30 |
| 1154414084 | Marc Ernest Johnson | Dentist | 1407 Kresky Ave, Centralia, WA 98531-8912 | 2006-10-02 |
| 1912011149 | Greg Taylor Swartz | Dentist | 102 N Allen St, Centralia, MO 65240-1394 | 2006-08-17 |
| 1134735277 | Kyle O'connor | Dentist | 2401 Borst Ave, Centralia, WA 98531-1411 | 2020-09-22 |
| 1467681999 | Nari Cho | Dentist | 135 S Sycamore St, Centralia, IL 62801-3525 | 2009-07-06 |
| Find all providers in CENTRALIA | ||||
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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.