DR. EVERETT CORNISH CROUCH JR. (NPI# 1417237363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417237363 |
| Entity Type | Individual |
| Full Name | DR. EVERETT CORNISH CROUCH JR. |
| Credential | D.D.S. |
| Practice Address |
6073 San Jose Blvd, West Jacksonville FL 32217 |
| Mailing Address |
6073 San Jose West Dr E C Crouch Jacksonville FL 32214 |
| Practice Telephone | 9047372111 |
| Practice Fax Number | 9077372207 |
| Mailing Telephone | 9047372111 |
| Mailing Fax Number | 9047372207 |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2011-08-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 3080 | FL | Dental Providers |
| Street Address |
6073 SAN JOSE BLVD, WEST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336605005 | Mary Ellen Mccullough-list | Behavior Technician | 3437 Miruelo Circle North, Jacksonville, FL 32217 | 2019-02-18 |
| 1285131656 | Priority One Home Care LLC | In Home Supportive Care | 7500 Powers Ave Apt 198, Jacksonville, FL 32217 | 2018-04-11 |
| 1407361272 | Sharon Williams | Home Health | 8300 Plaza Gate Lane #1152, Jacksonville, FL 32217 | 2017-12-02 |
| 1548779929 | Acumed Medical Ltd. | Durable Medical Equipment & Medical Supplies | 6653 Powers Avenue, Suite 134, Jacksonville, FL 32217 | 2017-09-28 |
| 1437685526 | Ward Zeigler | Behavior Technician | 3437 Miruelo Cr. N., Jacksonville, FL 32217 | 2017-05-10 |
| 1538695754 | Shilonda Peterson-jackson | Technician, Other | 3437 Miruelo Cr N, Jacksonville, FL 32217 | 2017-05-08 |
| 1114467834 | Louis R. Lothman | Counselor | 3734 San Viscaya Dr., Jacksonville, FL 32217 | 2017-02-28 |
| 1023490141 | A Gentle Touch Home Health Care LLC. | Home Health | 5991 Chester Avenue, Jacksonville, FL 32217 | 2015-06-25 |
| 1912320334 | Christopher Marshall Fuller | Developmental Therapist | 5132 Edgeware Ct., Jacksonville, FL 32217 | 2014-01-22 |
| 1790040020 | Maria R. Tapia | Psychologist | 7680 Smullian Trail West, Jacksonville, FL 32217 | 2012-07-12 |
| Find all providers in zip 32217 | ||||
| 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 |
|---|---|---|---|---|
| 1902419864 | Andre M Fang | Dentist | 6801 Roosevelt Blvd, Jacksonville, FL 32212-1192 | 2020-08-28 |
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1093323479 | Britney Marie Cruz | Dentist | 1280 Western Blvd Unit 200, Jacksonville, NC 28546-7658 | 2020-07-21 |
| 1083238786 | Sleep Better Solutions LLC | Dentist | 4215 Southpoint Blvd Ste 240, Jacksonville, FL 32216-0932 | 2020-05-29 |
| 1114550258 | James Moran | Dentist | 7990 Baymeadows Rd E # 718, Jacksonville, FL 32256-2961 | 2020-02-18 |
| 1265075329 | Latoya Goins | Dentist | 1280 Western Blvd, Jacksonville, NC 28546-6653 | 2019-10-22 |
| 1437706462 | Stephanie Marquez | Dentist | 751 Oak St Ste 601, Jacksonville, FL 32204-3373 | 2019-08-23 |
| 1831751064 | Rachel Marie Schloth | Dentist | 12086 Fort Caroline Rd Ste 105, Jacksonville, FL 32225-2688 | 2019-07-09 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1235796954 | Carolina Garcia | Dentist | 790 Skymarks Dr Ste 109, Jacksonville, FL 32218-7267 | 2019-05-29 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32217 |
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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.