CULBERSON R BOREN DDS (NPI# 1215208947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215208947 |
| Entity Type | Organization |
| Organization Name | CULBERSON R BOREN DDS |
| Practice Address |
1634 S Jackson St Jacksonville TX 75766-3028 |
| Practice Telephone | 9035812198 |
| Practice Fax Number | 9035819571 |
| Mailing Telephone | 9035812198 |
| Mailing Fax Number | 9035819571 |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2012-01-26 |
| Authorized Official Name | DR. CULBERSON REEVES BOREN (OWNER/ DENTIST) |
| Authorized Official Telephone | 9035812198 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
13063 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 008045901 | 05 |
| Street Address |
1634 S JACKSON ST |
| City | JACKSONVILLE |
| State | TX |
| Zip Code | 75766-3028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770062788 | David Rentz | Occupational Therapy Assistant | 838 Brown St., Jacksonville, TX 75766 | 2018-08-09 |
| 1295233146 | Amanda Dawn Anderson | Licensed Vocational Nurse | Fm 347, Jacksonville, TX 75766 | 2018-01-25 |
| 1467896241 | Christopher Mark Sirianni | Anesthesiology | 2026 S Jackson St Apt 1213, Jacksonville, TX 75766 | 2013-04-23 |
| 1164703047 | Aegis Psychological Consulting LLC | Psychologist | 208 E. Rusk St., Jacksonville, TX 75766 | 2011-09-06 |
| 1952697872 | Melissa Springmeyer | Family Medicine | 2026 South Jacksonville Street, Jacksonville, TX 75766 | 2011-06-20 |
| 1306031018 | Michael Kay Moore | Occupational Therapist | 4155 Cr 3908, Jacksonville, TX 75766 | 2007-09-06 |
| 1730398827 | Cherokee County Health Department | Public Health or Welfare | 510 East Commerce, Jacksonville, TX 75766 | 2007-05-22 |
| 1568689545 | Mary Alice Bone | Preventive Medicine | 510 E. Commerce, Jacksonville, TX 75766 | 2007-04-19 |
| 1619093176 | Assisted Living Concepts Inc | Assisted Living Facility | 211 Phillip Street, Jacksonville, TX 75766 | 2007-03-22 |
| 1265560767 | Anderson Cherokee Community Enrichment Services | Counselor | 1011 College Ave, Jacksonville, TX 75766 | 2007-02-28 |
| Find all providers in zip 75766 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558701177 | Richard W Blake Dds Pa | Dentist | 943 Cesery Blvd Ste D, Jacksonville, FL 32211-5655 | 2013-06-27 |
| 1336405315 | Matthew Allen Swan | Dentist | 3714 Heath Rd Fl 32277, Jacksonville, FL 32277-2045 | 2012-04-04 |
| 1871755512 | Barry Philip Setzer | Dentist | 8355 Bayberry Rd, Jacksonville, FL 32256-4427 | 2008-06-25 |
| 1639370216 | Thomas Arch Pribisco | Dentist | 10822 Saint Augustine Rd, Jacksonville, FL 32257-1154 | 2007-05-30 |
| 1932317922 | Jodi Eve Mason | Dentist | 2008 Riverside Ave, Suite 101, Jacksonville, FL 32204-4443 | 2007-05-21 |
| 1679606768 | Marzieh Zahedi | Dentist | 14453 Beach Blvd, Suite 100, Jacksonville, FL 32250 | 2007-03-14 |
| 1780734251 | Jila J Mahajan | Dentist | 4495 Roosevelt Blvd Ste 111, Jacksonville, FL 32210-3382 | 2007-01-10 |
| 1558467498 | Barry P Setzer Dds and Stephen D Cochran Dmd Pa | Dentist | 8355 Bayberry Road, Jacksonville, FL 32256 | 2006-09-16 |
| 1912014937 | Pediatric Smiles, Inc | Dentist | 2262 Dunn Ave, Ste 4, Jacksonville, FL 32218 | 2006-08-24 |
| 1558477414 | Staci Suggs | Dentist | 1651 Southside Connector Blvd., #1, Jacksonville, FL 32225 | 2006-08-22 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 75766 |
Please comment or provide details below to improve the information on CULBERSON R BOREN DDS.
| 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.