ELI TANIOS JARJOURA (NPI# 1235253014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235253014 |
| Entity Type | Individual |
| Full Name | ELI TANIOS JARJOURA |
| Credential | DDS |
| Practice Address |
3431 S Boulevard St Ste 102 Edmond OK 73013-5514 |
| Practice Telephone | 4058448887 |
| Mailing Telephone | 4058448887 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5325 | OK | Dental Providers |
| Street Address |
3431 S BOULEVARD ST STE 102 |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-5514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255531844 | Robert Orrin Baird | Dentist | 3431 S Boulevard St Ste 102, Edmond, OK 73013-5514 | 2007-07-20 |
| 1669596243 | Eric Ryan Massad | Dentist | 3431 S Boulevard St Ste 102, Edmond, OK 73013-5514 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
| Find all providers in zip 73013 | ||||
| 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 |
|---|---|---|---|---|
| 1154945202 | Korbin Hally | Dentist | 2600 Tayler Street, Edmond, OK 73003 | 2020-06-04 |
| 1730748773 | Tri Nguyen | Dentist | 2325 Nw 153rd St, Edmond, OK 73013-9229 | 2019-06-12 |
| 1497247860 | Preston Eugene Harraman | Dentist | 775 W Covell Rd Ste 160, Edmond, OK 73003-2302 | 2018-06-01 |
| 1346698842 | Jason Wallace | Dentist | 1400 W Covell Rd, Edmond, OK 73003-3504 | 2016-05-25 |
| 1013311265 | Dental Professionals of Ok, PC | Dentist | 3152 S Broadway, Edmond, OK 73013-4056 | 2014-10-17 |
| 1033519012 | Roger Potts Dental Group, PC | Dentist | 1333 N Santa Fe Ave Ste 105, Edmond, OK 73003-3677 | 2014-08-27 |
| 1588077150 | Krystal Dawn Hall | Dentist | 21026 Highlander Ridge Dr, Edmond, OK 73012-0902 | 2014-06-11 |
| 1497023196 | Tapan Koticha | Dentist | 16430 Muirfield Place, Edmond, OK 73013-9161 | 2011-12-08 |
| 1922394261 | William Samuel Ward | Dentist | 1354 E 15th St, Edmond, OK 73013-5029 | 2011-06-24 |
| 1083904833 | Dawn Annette Hisey | Dentist | 1140 Brookside Ct, Edmond, OK 73025-9748 | 2011-04-13 |
| Find all providers in EDMOND | ||||
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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.