DR. JERRY B BOOTH


Address: 683 Robinson Rd, Jackson, MI 49203-1155
Phone: 5177870417

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
JB008016 MI Dental Providers

Office Location

Street Address 683 ROBINSON RD
City JACKSON
State MI
Zip Code 49203-1155

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

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

Providers in the same taxonomy and city

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

Competitor

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City JACKSON
Zip Code 49203

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Dataset Information

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.

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