JEFFERSON COMPREHENSIVE CARE SYSTEM INC (NPI# 1023277746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023277746 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COMPREHENSIVE CARE SYSTEM INC |
| Other Organization Name | DENTAL CLINIC |
| Practice Address |
1101 Tennessee St Pine Bluff AR 71601-5801 |
| Mailing Address |
Po Box 1285 Pine Bluff AR 71613-1285 |
| Practice Telephone | 8705432341 |
| Practice Fax Number | 8705354716 |
| Mailing Telephone | 8705432341 |
| Mailing Fax Number | 8705354716 |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-06 |
| Authorized Official Name | MR. LARNELL W DAVIS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8705432380 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 102953631 | 05 |
| Other Name | Type Code |
|---|---|
| Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053571711 | Jefferson Comprehensive Care System Inc | Clinic/Center | 1101 Tennssee, Pine Bluff, AR 71601 | 2008-06-16 |
| 1396904017 | Jefferson Comprehensive Care System Inc | Clinic/Center | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2008-06-06 |
| Street Address |
1101 TENNESSEE ST |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71601-5801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154386597 | Jefferson Comprehensive Care System, Inc | Clinic/Center | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2006-04-19 |
| 1396904017 | Jefferson Comprehensive Care System Inc | Clinic/Center | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2008-06-06 |
| 1477766111 | Roosevelt Brown | Dentist | 1101 Tennessee St, Pine Bluff, AR 71601 | 2007-05-08 |
| 1184680746 | Margaret Ann Washington | Family Medicine | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2006-04-24 |
| 1700842614 | Paul L Smith | Pediatrics | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2006-04-21 |
| 1083670830 | Manuel R Kelley | Family Medicine | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2006-04-21 |
| 1861457988 | Rose A Pace | Family Medicine | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2006-04-20 |
| 1992760029 | Estelita M Quimosing | Internal Medicine | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2006-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162863 | Kb's Adult Health Day Care Center | Clinic/Center | 2911 South Market Street, Pine Bluff, AR 71601 | 2020-10-19 |
| 1184244600 | Chelsea Briggs | Prosthetic/Orthotic Supplier | 601 S Main St Apt 514, Pine Bluff, AR 71601 | 2020-04-24 |
| 1407489081 | Katherine Bolden | Clinic/Center | 2911 East Market Street, Pine Bluff, AR 71601 | 2020-02-21 |
| 1851836829 | Rocky Mountain Holdings, LLC | Ambulance | 613b Hangar Row, Pine Bluff, AR 71601 | 2016-12-30 |
| 1316324494 | Nora Elizabeth Horton | Specialist/Technologist | 2003 University Drive, Suite 2, Pine Bluff, Ar, AR 71601 | 2015-04-28 |
| 1780003665 | Sameer R. Shelat | Internal Medicine | 4125, Rhinehart Road, Pine Bluff, AR 71601 | 2014-04-08 |
| 1700150471 | Community Empowerment Council, Inc. | Social Worker | 5830 Hwy 65 South, Pine Bluff, AR 71601 | 2012-02-28 |
| 1922243807 | The Pine Bluff Group, Pllc | Chiropractor | 2102 S. Olive St., Pine Bluff, AR 71601 | 2008-12-08 |
| 1053571711 | Jefferson Comprehensive Care System Inc | Clinic/Center | 1101 Tennssee, Pine Bluff, AR 71601 | 2008-06-16 |
| 1144404799 | The P.a.t. (people Advocating Transition) Center | Counselor | 620 South Laurel, Pine Bluff, AR 71601 | 2007-12-18 |
| Find all providers in zip 71601 | ||||
| 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 |
|---|---|---|---|---|
| 1457805376 | Brent Herring | Dentist | 3721 S Olive St Ste B, Pine Bluff, AR 71603-6756 | 2016-08-09 |
| 1588927941 | David Keith Jones | Dentist | 1301 Ridgway Rd Ste 2b, Pine Bluff, AR 71603-7608 | 2012-06-20 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1639396807 | Drew William Toole | Dentist | 4100 W 28th Ave, Pine Bluff, AR 71603-4726 | 2007-04-19 |
| 1467559971 | Marvin Quincy Caudle | Dentist | 1310 South Linden St, Pine Bluff, AR 71603 | 2006-09-19 |
| 1881700995 | Joel F. Foster | Dentist | 1400 W 42nd Ave, Pine Bluff, AR 71603-7003 | 2006-08-22 |
| 1013576933 | Garrett Taylor, Dds, Pa | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-13 |
| 1841762200 | Abdullah Sufian Elassouli | Dentist | 1400 W 42nd Ave, Pine Bluff, AR 71603-7003 | 2018-12-26 |
| 1013490218 | John Philip Mckenzie Davis | Dentist | 4100 W 28th Ave, Pine Bluff, AR 71603-4726 | 2018-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235743352 | Varsha Patel | Dentist | 130 Harkrider St, Conway, AR 72032-6623 | 2020-09-04 |
| 1174132914 | John S Teed | Dentist | 800 Vista Cv, Marion, AR 72364-9704 | 2020-07-28 |
| 1891303509 | Brandt Thomas Cooper | Dentist | 1685 Airport Rd, Hot Springs, AR 71913-7951 | 2020-07-20 |
| 1174141667 | Anslee Latourette | Dentist | 8239 Rogers Ave, Fort Smith, AR 72903-5553 | 2020-07-10 |
| 1073139960 | Leona C. Kemper, Dds, Pa | Dentist | 6189 Heber Springs Rd West, Quitman, AR 72131 | 2020-06-17 |
| 1225652670 | David Barry Riggs | Dentist | 800 Locust Ave, Conway, AR 72034-5331 | 2020-06-02 |
| 1497378137 | Evgeny Titov | Dentist | 2501 Market Trce Ste A, Fort Smith, AR 72908-8881 | 2020-05-28 |
| 1306469382 | Phipps Family Dentistry | Dentist | 807 W Centerton Blvd, Centerton, AR 72719-9705 | 2020-05-25 |
| 1831711910 | Brian Lane D D S Pa | Dentist | 17 Eagle Park Dr, Vilonia, AR 72173-9050 | 2020-05-12 |
| 1215557897 | Wh Ar Dental Pllc | Dentist | 4870 Elm Springs Rd Ste B, Springdale, AR 72762-3749 | 2020-04-23 |
| Find all providers with the same taxonomy | ||||
| City | PINE BLUFF |
| Zip Code | 71601 |
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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.