DR. JACK H WEAVER (NPI# 1043238389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043238389 |
| Entity Type | Individual |
| Full Name | DR. JACK H WEAVER |
| Credential | DDS |
| Practice Address |
3712 Canyon Lake Dr Rapid City SD 57702-3198 |
| Mailing Address |
4716 Guest Rd Rapid City SD 57702-4815 |
| Practice Telephone | 6053423939 |
| Practice Fax Number | 6053412766 |
| Mailing Telephone | 6054844484 |
| Mailing Fax Number | 6053412766 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
M366 | SD | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184055048 | Jack Weaver Jr. | Counselor | 521 Gault Ave N, Fort Payne, AL 35967-2307 | 2013-12-03 |
| 1558342154 | Jack David Weaver | Chiropractor | 3051 Victor Ave, Redding, CA 96002-1450 | 2005-11-10 |
| 1902802101 | Jack Eugene Weaver | Specialist | 209 S 36th St, Muskogee, OK 74401-5043 | 2005-06-22 |
| Street Address |
3712 CANYON LAKE DR |
| City | RAPID CITY |
| State | SD |
| Zip Code | 57702-3198 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275131013 | Elden M Rice Dds PC | Clinic/Center | 3712 Canyon Lake Dr, Rapid City, SD 57702-3198 | 2020-10-14 |
| 1184827503 | Larry Froistad | Dentist | 3712 Canyon Lake Dr, Rapid City, SD 57702-3198 | 2007-06-06 |
| 1841492063 | Robert O'neal Saunders | Dentist | 3712 Canyon Lake Dr, Rapid City, SD 57702-3198 | 2007-06-01 |
| 1982813440 | Saunders & Anderson Dds PC | Dentist | 3712 Canyon Lake Dr, Rapid City, SD 57702-3198 | 2007-05-22 |
| 1699866756 | Area Dental Associates PC | Dentist | 3712 Canyon Lake Dr, Rapid City, SD 57702-3198 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366049660 | Byrne Dental, Professional LLC | Dentist | 3825 Canyon Lake Dr, Rapid City, SD 57702 | 2020-10-08 |
| 1427603026 | Mikaela Licht | Technician | 4310 Cedar Ridge Pl. Apt #5, Rapid City, SD 57702 | 2019-08-09 |
| 1932761335 | Great Plains Tribal Chairmen's Health Board | Pharmacy | Oyate Health Center, 3200 Canyon Lake Drive, Rapid City, SD 57702 | 2019-07-05 |
| 1598231334 | Regional Health Physicians, Inc. | Clinic/Center | 1635 Caregiver Circle, Rapid City, SD 57702 | 2018-10-19 |
| 1851813224 | Angie Deneire | Licensed Practical Nurse | 7312 Pinon Jay Circle, Rapid City, SD 57702 | 2017-07-07 |
| 1073063830 | Kirsten William-kennedy Dds, Ms, P.C. | Dentist | 740 Sheridan Lk. Rd. Suite A, Rapid City, SD 57702 | 2016-10-05 |
| 1932558939 | Emily T Rausch | Physical Therapist | 2040 West Main, #212, Rapid City, SD 57702 | 2016-06-09 |
| 1033597810 | John Dennis Burke | Speech-Language Pathologist | 4635 Wentworth Drive, Rapid City, SD 57702 | 2015-05-12 |
| 1013394535 | Dakota Regional Periodontics | Dentist | 2800 Jackson Blvd #6, Rapid City, SD 57702 | 2015-05-05 |
| 1306272414 | Lindsy Jo Wathen | Speech-Language Pathologist | 13232 Klondike Road, Rapid City, SD 57702 | 2013-09-20 |
| Find all providers in zip 57702 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727969 | Shaun Lemmon | Dentist | 333 West Blvd # 300a, Rapid City, SD 57701-2670 | 2020-10-14 |
| 1366049660 | Byrne Dental, Professional LLC | Dentist | 3825 Canyon Lake Dr, Rapid City, SD 57702 | 2020-10-08 |
| 1376197533 | Richard Brady Perdue | Dentist | 2606 Elderberry Blvd, Rapid City, SD 57703 | 2019-07-26 |
| 1508424680 | Joshua Petersen | Dentist | 1687 Tablerock Rd, Rapid City, SD 57701-5495 | 2019-06-03 |
| 1063904290 | Brittni Rose Reichert | Dentist | 6005 Mount Rushmore Rd, Rapid City, SD 57701-8962 | 2018-06-04 |
| 1598279028 | Schmalz Dental LLC | Dentist | 1147 Eglin St, Rapid City, SD 57701-9612 | 2017-11-20 |
| 1649556978 | Moody Dental Implant Centers LLC | Dentist | 705 Columbus St, Rapid City, SD 57701-3623 | 2011-11-01 |
| 1134417058 | Rob Dean Lyons | Dentist | 5955 Mount Rushmore Rd Ste A, Rapid City, SD 57701 | 2011-07-12 |
| 1083852826 | Tracy Krafthefer Heeter | Dentist | 685 N Lacrosse St, Rapid City, SD 57701-1492 | 2009-02-02 |
| 1568611374 | Charles F. Scanlon II | Dentist | 5955 South Highway 16, Suite A, Rapid City, SD 57701-8911 | 2008-09-17 |
| Find all providers in RAPID CITY | ||||
| City | RAPID CITY |
| Zip Code | 57702 |
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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.