DR. JERRY KENNETH WELDON JR. (NPI# 1013956606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013956606 |
| Entity Type | Individual |
| Full Name | DR. JERRY KENNETH WELDON JR. |
| Credential | D.M.D. |
| Practice Address |
172 Professional Park Dr Clarkesville GA 30523-5536 |
| Practice Telephone | 7067541015 |
| Practice Fax Number | 7067543359 |
| Mailing Telephone | 7067541015 |
| Mailing Fax Number | 7067543359 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
011386 | GA | Dental Providers |
| Street Address |
172 PROFESSIONAL PARK DR |
| City | CLARKESVILLE |
| State | GA |
| Zip Code | 30523-5536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275660904 | J Kenneth Weldon, Jr, Dmd LLC | Dentist | 172 Professional Park Dr, Clarkesville, GA 30523-5536 | 2007-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334209 | Mark Alan Beach | Counselor | 320 Victory Home Ln, Clarkesville, GA 30523 | 2020-10-21 |
| 1619299799 | Leonard Fishman | Specialist | 500 Blue Creek Rd, Clarkesville, GA 30523 | 2010-02-17 |
| 1710134051 | Cheston Berrong Kimsey, Jr | Dentist | 364 Jefferson St, Clarkesville, GA 30523 | 2008-08-19 |
| 1558535302 | Dr David S Greene | Optometrist | 337 Madison St, Clarksville, GA 30523 | 2008-04-14 |
| 1124160049 | Colleen M. Colegrove | Pharmacist | 199 East Louise St, Clarkesville, GA 30523 | 2007-02-14 |
| 1437290541 | Hope Lucinda Senador | Social Worker | 1423 Washington Street, Suite 210, Clarkesville, GA 30523 | 2007-02-09 |
| 1326188855 | Clarkesville Counseling & Mediation Services, Inc | Counselor | 695 Washington St, Clarkesville, GA 30523 | 2007-02-07 |
| 1013057546 | Centerpoint Counseling Services | Social Worker | 1423 Washington St, Ste 202, Clarkesville, GA 30523 | 2007-02-07 |
| 1588722276 | Regina Ann Boling | Dentist | 5332 Hwy 115, Suite A, Clarkesville, GA 30523 | 2006-12-05 |
| 1881761450 | Cummings Physical Therapy Services, LLC | Specialist | 1179 Ben Jones Road, Clarkesville, GA 30523 | 2006-11-29 |
| Find all providers in zip 30523 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275660904 | J Kenneth Weldon, Jr, Dmd LLC | Dentist | 172 Professional Park Dr, Clarkesville, GA 30523-5536 | 2007-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437764180 | John O. Green, II, Dds, PC | Dentist | 6126 Prestley Mill Rd Ste J, Douglasville, GA 30134-5624 | 2020-09-10 |
| 1104434232 | Conyers Endodontic Center PC | Dentist | 1920 Highway 20 Se Ste A, Conyers, GA 30013-2048 | 2020-07-15 |
| 1790288678 | Crabapple Endodontics | Dentist | 12385 Crabapple Rd Ste 150, Alpharetta, GA 30004-6357 | 2018-03-16 |
| 1326552522 | Lucas Blaine Connor | Dentist | 3625 Braselton Hwy Ste 101, Dacula, GA 30019-4696 | 2017-11-27 |
| 1710382007 | Golden Isles Endodontics, LLC | Dentist | 1804 Frederica Rd Ste B, Saint Simons Island, GA 31522-2044 | 2014-10-29 |
| 1346644176 | Liberty Trails Endodontics, LLC | Dentist | 111 E Mills Ave, Hinesville, GA 31313-2616 | 2014-10-22 |
| 1194136929 | Jimmy W. Arnold | Dentist | 152 N Crest Blvd Ste A, Macon, GA 31210-1847 | 2014-05-14 |
| 1629418371 | Young Okeke | Dentist | 6595 Roswell Rd Ste G-3040, Atlanta, GA 30328-3152 | 2013-06-26 |
| 1720342694 | Lake Oconee Endodontics, LLC | Dentist | 112 Harmony Crossing, Suite 1, Eatonton, GA 31024-9536 | 2012-06-26 |
| 1275891541 | Alison Stpaul | Dentist | 1705 Ga-20, Suite 200, Mcdonough, GA 30253 | 2012-04-24 |
| Find all providers with the same taxonomy | ||||
| City | CLARKESVILLE |
| Zip Code | 30523 |
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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.