ETHAN DUEWER (NPI# 1972023117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972023117 |
| Entity Type | Individual |
| Full Name | ETHAN DUEWER |
| Credential | DMD |
| Practice Address |
1440 W Walnut St Jacksonville IL 62650-1143 |
| Mailing Address |
2239 E Cook St Springfield IL 62703-1944 |
| Practice Telephone | 2177882300 |
| Mailing Telephone | 2177882300 |
| Mailing Fax Number | 2177882343 |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 019.031206 | IL | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2239 E Cook St, Springfield, IL 627031944 | (217) 788-2300 | 2177882343 |
| Street Address |
1440 W WALNUT ST |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650-1143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770576829 | Peter Damon Russotto | Podiatrist | 1440 W Walnut St, #5, Jacksonville, IL 62650-1143 | 2005-08-24 |
| 1205282936 | Central Counties Health Centers, Inc. | Physician Assistant | 1440 W Walnut St, Suite 2, Jacksonville, IL 62650-1143 | 2016-05-12 |
| 1114322286 | Jersey Community Hospital | Pediatrics | 1440 W Walnut St, Suite 2a, Jacksonville, IL 62650-1143 | 2014-10-30 |
| 1891034294 | Illini Medical Associates, Sc | Pediatrics | 1440 W Walnut St, Ste 2a, Jacksonville, IL 62650-1143 | 2013-02-05 |
| 1558480418 | Physical Therapists Clinic,ltd | Clinic/Center | 1440 W Walnut St, Suite 2, Jacksonville, IL 62650-1143 | 2007-03-29 |
| 1083769475 | Physical Therapists Clinic, Ltd | Physical Therapist | 1440 W Walnut St, Suite2, Jacksonville, IL 62650-1143 | 2007-01-24 |
| 1174608533 | Donald Robert Beckett Jr. | Dentist | 1440 W Walnut St, Suite 2, Jacksonville, IL 62650 | 2006-10-26 |
| 1336179712 | Amy Jo Blanford | Physical Therapist | 1440 W Walnut St, Building #2, Jacksonville, IL 62650-1143 | 2006-07-03 |
| 1245203439 | Linda V Stevens-schilsky | Pediatrics | 1440 W Walnut St, Jacksonville, IL 62650 | 2006-02-09 |
| 1043299803 | Abby G Henry | Physical Therapist | 1440 W Walnut St, #2, Jacksonville, IL 62650-1143 | 2006-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| Find all providers in zip 62650 | ||||
| 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 |
|---|---|---|---|---|
| 1902419864 | Andre M Fang | Dentist | 6801 Roosevelt Blvd, Jacksonville, FL 32212-1192 | 2020-08-28 |
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1093323479 | Britney Marie Cruz | Dentist | 1280 Western Blvd Unit 200, Jacksonville, NC 28546-7658 | 2020-07-21 |
| 1083238786 | Sleep Better Solutions LLC | Dentist | 4215 Southpoint Blvd Ste 240, Jacksonville, FL 32216-0932 | 2020-05-29 |
| 1114550258 | James Moran | Dentist | 7990 Baymeadows Rd E # 718, Jacksonville, FL 32256-2961 | 2020-02-18 |
| 1265075329 | Latoya Goins | Dentist | 1280 Western Blvd, Jacksonville, NC 28546-6653 | 2019-10-22 |
| 1437706462 | Stephanie Marquez | Dentist | 751 Oak St Ste 601, Jacksonville, FL 32204-3373 | 2019-08-23 |
| 1831751064 | Rachel Marie Schloth | Dentist | 12086 Fort Caroline Rd Ste 105, Jacksonville, FL 32225-2688 | 2019-07-09 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1235796954 | Carolina Garcia | Dentist | 790 Skymarks Dr Ste 109, Jacksonville, FL 32218-7267 | 2019-05-29 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
Please comment or provide details below to improve the information on ETHAN DUEWER.
| 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.