DR. JEFFREY MAX BATESOLE (NPI# 1306250642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306250642 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY MAX BATESOLE |
| Credential | D.D.S |
| Practice Address |
9121 Illinois Rd Fort Wayne IN 46804-5753 |
| Practice Telephone | 2602418454 |
| Mailing Telephone | 2602418454 |
| Enumeration Date | 2014-06-15 |
| Last Update Date | 2018-04-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D10220 | OR | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
12012144A | IN | Dental Providers |
| Street Address |
9121 ILLINOIS RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-5753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255957585 | Ashley Renee Gabrek | Dentist | 9121 Illinois Rd, Fort Wayne, IN 46804-5753 | 2020-06-23 |
| 1811531007 | Tmj & Sleep Therapy Centre of Fort Wayne, LLC | Dentist | 9121 Illinois Rd, Fort Wayne, IN 46804-5753 | 2019-10-31 |
| 1730619479 | Aaron Light | Dentist | 9121 Illinois Rd, Fort Wayne, IN 46804-5753 | 2017-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669025037 | Emma Kathleen O'heeney | Dentist | 9405 Illinois Rd, Fort Wayne, IN 46804-5795 | 2019-07-24 |
| 1023670874 | Cory Kappesser | Dentist | 10505 Lima Rd, Fort Wayne, IN 46818-9536 | 2019-07-02 |
| 1558843698 | John Lawrence Bixler | Dentist | 7207 Engle Rd Ste 2, Fort Wayne, IN 46804-2231 | 2018-09-05 |
| 1366960445 | Chelsea L Schafer | Dentist | 2828 E State Blvd Ste A, Fort Wayne, IN 46805-4761 | 2017-09-08 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1740697945 | Vishali Sharma | Dentist | 4716 Illinois Rd, Fort Wayne, IN 46804-5122 | 2014-07-20 |
| 1891120382 | Salkeld Family Dental, LLC | Dentist | 12962 Coldwater Rd, Fort Wayne, IN 46845-9517 | 2013-09-04 |
| 1205272168 | Tyler Jerome Kimmel | Dentist | 1717 S. Calhoun Street, Fort Wayne, IN 46802 | 2013-05-20 |
| 1467726851 | Gentle Care Family Dentistry | Dentist | 2444 Getz Rd, Fort Wayne, IN 46804-1632 | 2012-03-02 |
| 1962780403 | Nicholas Kent Rorick | Dentist | 10082 Illinois Road, Fort Wayne, IN 46804 | 2011-08-02 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on DR. JEFFREY MAX BATESOLE.
| 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.