SIMUEL LAZAAR JAMISON (NPI# 1467438523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467438523 |
| Entity Type | Individual |
| Full Name | SIMUEL LAZAAR JAMISON |
| Credential | DMD |
| Practice Address |
Dept of The Army, Dental Activity, Stop B 2817 Reilly Rd, Mcds-na-b Fort Bragg NC 28310-0001 |
| Practice Telephone | 9103965610 |
| Practice Fax Number | 9103967017 |
| Mailing Telephone | 9103965610 |
| Mailing Fax Number | 9103967017 |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
7435 | KY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FEDERAL DEA | BJ7032244 | 01 |
| Street Address |
DEPT OF THE ARMY, DENTAL ACTIVITY, STOP B 2817 REILLY RD, MCDS-NA-B |
| City | FORT BRAGG |
| State | NC |
| Zip Code | 28310-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073583100 | Alfred Christian Anderson | Dentist | Dept of The Army, Dental Activity, Stop B, 2817 Reilly Rd, Mcds-na-b, Fort Bragg, NC 28310-0001 | 2006-01-23 |
| 1558340398 | Michael Karl Speth | Dentist | Dept of The Army, Dental Activity, Stop B, 2817 Reilly Rd, Mcds-na-b, Fort Bragg, NC 28310-0001 | 2006-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013550763 | Brent Francis Bachman | Physician Assistant | 2817 Reilly Street, Fort Bragg, NC 28310 | 2019-10-25 |
| 1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
| 1851959951 | Daniel Jordan Whitaker | Student in an Organized Health Care Education/Training Program | Womack Army Medical Center, 2817 Reilly Road, Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2019-06-03 |
| 1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
| 1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
| 1457843831 | Kevin Patrick Hudson | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road Mxcx - Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2018-06-01 |
| 1639691462 | Margaret S Greene | Dentist | Usa Dental Health Activity Fort Bragg, Wamc Box #151 2817 Rielly Rd, Fort Bragg, NC 28310 | 2017-07-13 |
| 1912432246 | Chezdan Baker | Student in an Organized Health Care Education/Training Program | Us Army Dental Health Activity Bldg-6837 Normandy Drive, Fort Bragg, NC 28310 | 2017-04-24 |
| 1215483094 | Shantryce Monique Boatwright Crump | Dental Hygienist | 2617 Rielly Road, Fort Bragg, NC 28310 | 2016-08-31 |
| 1629435714 | John Gagnier | Physician Assistant | Gruber Road, Building #c-1722, Fort Bragg, NC 28310 | 2016-01-21 |
| Find all providers in zip 28310 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427019082 | Cheryl Morgan | Dentist | Dept of The Army, Dental Activity Stop B, 2817 Reilly Rd, Mcds-na-b, Fort Bragg, NC 28310-0001 | 2006-03-31 |
| 1114997657 | Daniel Kent Bailey | Dentist | 2817 Reilly St, Mcds Na B Attn: Dentac Credentials, Fort Bragg, NC 28310-7302 | 2006-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669994703 | Ryan Alexander Matthews | Dentist | 140 Mahaley Ave Ste A, Salisbury, NC 28144-2449 | 2017-07-11 |
| 1386165736 | Susun Theresa Kim | Dentist | Dept of Prosthodontics, Unc School of Dentistry, 330 Brauer Hall, Chapel Hill, NC 27599 | 2017-07-06 |
| 1174933519 | Anthony Gragg | Dentist | 7201 Creedmoor Rd Ste 120, Raleigh, NC 27613-8000 | 2014-05-07 |
| 1558799916 | Mahmoud Serag | Dentist | 2712 W Arlington Blvd Apt 206, Greenville, NC 27834-4115 | 2013-10-23 |
| 1386990505 | Kevin Lim | Dentist | 302 Brauer Hl, Campus Boc 7450, Chapel Hill, NC 27599 | 2012-07-25 |
| 1639437163 | Keith A Mays | Dentist | Lakeside Annex 7, Ms 701, East Carolina University School of Dentistry, Greenville, NC 27834 | 2012-05-03 |
| 1740598374 | Alexandra B Yarborough | Dentist | Department of Prosthodontics, 338 Brauer Hall, Campus Box #7450, Chapel Hill, NC 27599-7450 | 2010-09-16 |
| 1821328865 | Benjamin E. Thompson | Dentist | 2904 Maplewood Ave, Winston Salem, NC 27103-4010 | 2010-01-13 |
| 1447427760 | Lisa N Powell | Dentist | 150 Preston Executive Drive, Suite 204, Cary, NC 27513 | 2008-05-15 |
| 1750551297 | John A Murrell | Dentist | 2605 Blue Ridge Rd Ste 310, Raleigh, NC 27607-6475 | 2008-03-11 |
| Find all providers with the same taxonomy | ||||
| City | FORT BRAGG |
| Zip Code | 28310 |
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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.