DR. JERRY B BOOTH (NPI# 1134224116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134224116 |
Entity Type | Individual |
Full Name | DR. JERRY B BOOTH |
Credential | D.D.S, M.S. |
Practice Address |
683 Robinson Rd Jackson MI 49203-1155 |
Mailing Address |
4595 Eagle Dr Jackson MI 49201-9746 |
Practice Telephone | 5177870417 |
Practice Fax Number | 5177875536 |
Mailing Telephone | 5177840796 |
Enumeration Date | 2006-09-14 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
JB008016 | MI | Dental Providers |
Street Address |
683 ROBINSON RD |
City | JACKSON |
State | MI |
Zip Code | 49203-1155 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962659680 | Ronnie Ray Sorrow Jr. | Dentist | 683 Robinson Rd, Jackson, MI 49203-1155 | 2008-08-25 |
1639369358 | Cardon & Sorrow Oral and Maxillofacial Surgery Plc | Dentist | 683 Robinson Rd, Jackson, MI 49203-1155 | 2007-07-30 |
1851496830 | Orson P Cardon | Dentist | 683 Robinson Rd, Jackson, MI 49203-1155 | 2006-09-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760900120 | Cynthia A Rider Dmd Pllc | Oral & Maxillofacial Surgery | 2545 Spring Arbor Road, Suite 202, Jackson, MI 49203 | 2017-09-06 |
1407224280 | Lucinda Gail Taggart | Licensed Practical Nurse | 1515 Greenwood Ave., Jackson, MI 49203 | 2015-09-10 |
1134514045 | Christopher Dauterman | Registered Nurse | 1320 East Mcdevitt, Jackson, MI 49203 | 2015-03-30 |
1710386826 | Steven Andrew Edwards | Social Worker | 505 Hickory Court, #2d, Jackson, MI 49203 | 2014-08-14 |
1861800666 | Michigan Continuum Care Pllc | Internal Medicine | 1310 Greenwood Ave., Jackson, MI 49203 | 2014-07-25 |
1497014831 | Barbara Cliffe-miller | Physical Therapist | 3510 Page Ave, Jackson, MI 49203 | 2012-05-04 |
1871822718 | Sharon Ann Arendsen | Respite Care | 4043 Clarkway Rd, Jackson, MI 49203 | 2009-12-23 |
1669700456 | Teresa Lynn Cox | Technician, Other | 3884 Franklin Rd., Jackson, MI 49203 | 2009-12-07 |
1942537097 | Stacy Marie Chinevere I | Counselor | 326 Johnson St, Jackson, MI 49203 | 2009-11-11 |
1366672370 | Sarah Elizabeth Hazlett | Counselor | 1522joy Avenue, Jackson, MI 49203 | 2009-07-24 |
Find all providers in zip 49203 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639792450 | Dr Riley PC | Dentist | 1325 S Hwy 89 Apt 105, Jackson, WY 83001-8293 | 2020-05-27 |
1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
1083852149 | Michael Stern | Dentist | 1160 Alpine Ln, Suite 1d, Jackson, WY 83001 | 2009-01-28 |
1144481961 | Nathan James Ostler | Dentist | 688 Brewers Bridge Rd, Jackson, NJ 08527-2017 | 2008-06-24 |
1437370988 | Kyle Tanner Hunt | Dentist | 971 Lakeland Dr Ste 952, Jackson, MS 39216-4609 | 2007-05-01 |
1215009980 | Rodney Arnell Hunt | Dentist | 971 Lakeland Dr Ste 600, Jackson, MS 39216-4608 | 2006-11-15 |
1225123078 | Cynthia A Rider | Dentist | 2545 Spring Arbor Rd., Suite 202, Jackson, MI 49203 | 2006-10-04 |
1609960749 | Maxillofacial Surgery Center of Central Mississippi | Dentist | 266 Katherine Dr, Jackson, MS 39232-8801 | 2006-10-03 |
1164430971 | Teton Oral & Maxillofacial Surgery | Dentist | 1160 Alpine Lane, #1d, Jackson, WY 83002 | 2006-08-04 |
1497732861 | John Walton Crowder | Dentist | 39 Murray Guard Dr, Jackson, TN 38305-3610 | 2005-12-28 |
Find all providers in JACKSON |
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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.