DR. KENNETH G MIZE (NPI# 1255338638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255338638 |
| Entity Type | Individual |
| Full Name | DR. KENNETH G MIZE |
| Credential | DMDPC |
| Practice Address |
411 W Main St Sheridan OR 97378-1117 |
| Mailing Address |
411 W Main St P.o. Box 100 Sheridan OR 97378-1117 |
| Practice Telephone | 5038434433 |
| Practice Fax Number | 5038434434 |
| Mailing Telephone | 5038434433 |
| Mailing Fax Number | 5038434434 |
| Enumeration Date | 2005-06-30 |
| 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 |
D5811 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493317 | Kenneth Ryan Mize | Social Worker | 3600 N Saginaw Rd, Midland, MI 48640-2301 | 2020-10-07 |
| Street Address |
411 W MAIN ST |
| City | SHERIDAN |
| State | OR |
| Zip Code | 97378-1117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467837344 | Cody Charron | Dentist | 411 W Main St, Sheridan, OR 97378-1117 | 2015-07-21 |
| 1801918255 | Kenneth G Mize Dmdpc | Dentist | 411 W Main St, Sheridan, OR 97378-1117 | 2007-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386757193 | Andrew Barnes Grasley | General Practice | 2702 Sw Ballston Road, Sheridan, OR 97378 | 2006-08-16 |
| 1902878333 | Kenneth A Kelley | Chiropractor | 639 W Main, Sheridan, OR 97378 | 2006-02-01 |
| 1790951440 | Sheridan Family Chiropractic PC | Chiropractor | 639 W Main, Sheridan, OR 97378 | 2008-05-02 |
| 1265959563 | Bettina Tamice Moore | Counselor | 901 W Main St, Sheridan, OR 97378-1003 | 2017-08-28 |
| 1689047680 | Thunderstruck Farms Inc. | Chiropractor | 639 W Main St, Sheridan, OR 97378-1121 | 2015-11-12 |
| 1013390939 | Tina Hargrove | Chiropractor | 639 W Main St, Sheridan, OR 97378-1121 | 2015-07-09 |
| 1598951634 | Julie Lynn Detamore | Acupuncturist | 552 Nw Evans St, Sheridan, OR 97378-1208 | 2007-09-21 |
| 1376076331 | Timothy Roaden | Peer Specialist | 356 Ne Faulconer Ct, Sheridan, OR 97378-1255 | 2017-04-06 |
| 1932238086 | Nancy Nunley | Registered Nurse | 220 Sw Jefferson St, Sheridan, OR 97378-1720 | 2007-03-05 |
| 1942273818 | Sheridan Fire District | Ambulance | 230 Sw Mill St, Sheridan, OR 97378-1729 | 2006-02-09 |
| Find all providers in zip 97378 | ||||
| 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 |
|---|---|---|---|---|
| 1710454012 | Michelle L Meehan, Dds | Dentist | 1465 Burton St Ste A, Sheridan, WY 82801-2746 | 2018-10-25 |
| 1679003909 | Jahon Thomas Zehtaban | Dentist | 1409 S Rock St Ste B, Sheridan, AR 72150-7180 | 2017-06-19 |
| 1336559475 | Riley Wedlake | Dentist | 3960 River Point Pkwy # A, Sheridan, CO 80110-3315 | 2014-04-29 |
| 1134469570 | Trenton Kyle Burrup | Dentist | 2 N Main St Ste 405, Sheridan, WY 82801-6324 | 2013-02-21 |
| 1942538384 | Brian Jeffrey Cook | Dentist | 941 Sugarland Dr Ste A, Sheridan, WY 82801-5380 | 2009-11-23 |
| 1407086366 | Matthew Bridwell | Dentist | 1310 S Rock St Ste 1, Sheridan, AR 72150-7223 | 2009-07-24 |
| 1770729204 | Paul D Fitzgerald, Dds | Dentist | 209 W Holly St, Sheridan, AR 72150-2425 | 2009-01-06 |
| 1720242902 | River Point Dental Group and Orthodontics LLP | Dentist | 3960 River Point Pkwy, Unit A, Sheridan, CO 80110 | 2008-07-16 |
| 1407052038 | Milton Siskin | Dentist | Coffeen Plaza Dental, 1003 Coffeen Avenue, Sheridan, WY 82801 | 2007-06-21 |
| 1144437963 | Cody L Coon | Dentist | 108 E Grinnell St, Sheridan, WY 82801-3938 | 2007-05-17 |
| Find all providers in SHERIDAN | ||||
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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.