DR. JAY EDWARD FANDEL (NPI# 1417040940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417040940 |
| Entity Type | Individual |
| Full Name | DR. JAY EDWARD FANDEL |
| Credential | D.M.D. |
| Practice Address |
5618 Woodbine Ln San Angelo TX 76904 |
| Practice Telephone | 3256543676 |
| Mailing Telephone | 3256543676 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 2612-91 | MS | Dental Providers |
| Street Address |
5618 WOODBINE LN |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407342702 | Mark Wandal Duncan | Specialist/Technologist | 2237 South Jackson, San Angelo, TX 76904 | 2018-07-10 |
| 1700267259 | Sheila Patterson | Nurse Practitioner | 4251 Sunset Drive, San Angelo, TX 76904 | 2015-06-10 |
| 1346649316 | Mason William Mcclintock | Dentist | 2402 College Hills Blvd. Building 1, Building 1, San Angelo, TX 76904 | 2014-08-15 |
| 1265855712 | Lynn M. Thebo, Lcsw, Pllc | Social Worker | 3109 Southwest Blvd. Ste. B, San Angelo, TX 76904 | 2014-02-03 |
| 1487077459 | Lynn Marie Thebo | Social Worker | 3109 Southwest Blvd., Ste. B, San Angelo, TX 76904 | 2014-01-28 |
| 1558646521 | John Porter Parker Jr. | Pharmacist | 3705 Threewn Trail, San Angelo, TX 76904 | 2011-10-20 |
| 1568772036 | Medical Alliance Group of Texas, LLC | Durable Medical Equipment & Medical Supplies | 2525 S Johnson Ste A, San Angelo, TX 76904 | 2010-10-18 |
| 1578796710 | Jennifer L White | Physical Therapist | 2237 S. Jackson, San Angelo, TX 76904 | 2009-09-03 |
| 1548443203 | Kelly K. Sawyer, D.d.s., P.a. | Dentist | 3013 W. Loop 306, San Angelo, TX 76904 | 2007-12-17 |
| 1023224789 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 1706 Idaho Avenue, San Angelo, TX 76904 | 2007-05-16 |
| Find all providers in zip 76904 | ||||
| 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 |
|---|---|---|---|---|
| 1225289929 | Robert Charles Mankin | Dentist | 6632 Pinehurst Dr, San Angelo, TX 76904-9308 | 2008-10-01 |
| 1558537316 | Daniel J Hinckley Dds | Dentist | 2141 Hamilton Way Ste 104, San Angelo, TX 76904-6887 | 2008-05-01 |
| 1306025580 | Leslie F Rick Williams | Dentist | 2102 Pecos, Suite 6, San Angelo, TX 76901-3061 | 2007-10-24 |
| 1609072396 | Charles Monroe Webb | Dentist | 324 E Harris, San Angelo, TX 76903 | 2007-06-21 |
| 1881897254 | Thomas Frederick Anderson | Dentist | 421 W Twohig, San Angelo, TX 76903 | 2007-06-06 |
| 1033228788 | Clifton J Montgomery | Dentist | 516 W Twohig, San Angelo, TX 76903 | 2006-08-29 |
| 1043324122 | Jack Houston Self | Dentist | 113 A & M St, San Angelo, TX 76901-3661 | 2006-08-18 |
| 1508809179 | Kenneth Anderson Rees | Dentist | 2149 Office Park Dr, San Angelo, TX 76904-6803 | 2006-06-13 |
| 1467444034 | David Christopher Henson | Dentist | 4333 College Hills Blvd, San Angelo, TX 76904-6919 | 2005-08-18 |
| 1942721006 | Kristin L. Goodwin | Dentist | 1897 Pecos St, San Angelo, TX 76901-3231 | 2017-06-29 |
| Find all providers in SAN ANGELO | ||||
| City | SAN ANGELO |
| Zip Code | 76904 |
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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.