SPRING DENTAL COLLINSVILLE, PLLC (NPI# 1477110963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477110963 |
| Entity Type | Organization |
| Organization Name | SPRING DENTAL COLLINSVILLE, PLLC |
| Practice Address |
1111 W Main St Collinsville OK 74021-3112 |
| Mailing Address |
400 Riverwalk Ter Ste 250 Jenks OK 74037-5619 |
| Practice Telephone | 9183713375 |
| Mailing Telephone | 9189980996 |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2019-05-21 |
| Authorized Official Name | CREED CARDON (OWNER) |
| Authorized Official Telephone | 9189980996 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Street Address |
1111 W MAIN ST |
| City | COLLINSVILLE |
| State | OK |
| Zip Code | 74021-3112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972587400 | James E Hereford | Dentist | 1111 W Main St, Collinsville, OK 74021-3112 | 2005-11-29 |
| 1548434558 | James E Hereford, Dds, Inc | Clinic/Center | 1111 W Main St, Collinsville, OK 74021-3112 | 2008-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982194254 | Bonnie J Johnston | Registered Nurse | 526 E Center St, Collinsville, OK 74021 | 2018-05-12 |
| 1508218959 | Constance Rogers | Family Medicine | 1205 W Main St, Collinsville, OK 74021 | 2016-07-11 |
| 1922597020 | Catherine Eimer | Case Manager/Care Coordinator | 18492 S View Point Ct, Collinsville, OK 74021-1516 | 2018-05-03 |
| 1982001756 | Julia Profit | Registered Nurse | 215 N 20th St, Collinsville, OK 74021-1604 | 2014-11-21 |
| 1417418666 | Andrea J Caygill | Physician Assistant | 216 N 20th St, Collinsville, OK 74021-1605 | 2019-03-29 |
| 1356452908 | St. John Villas Inc. | Nursing Facility/Intermediate Care Facility | 2300 W Broadway St, Collinsville, OK 74021-1625 | 2006-08-31 |
| 1770113771 | Erika Dawn Rector | Occupational Therapy Assistant | 2300 W Broadway St, Collinsville, OK 74021-1625 | 2020-01-19 |
| 1720506702 | City of Sapulpa | Skilled Nursing Facility | 2300 W Broadway St, Collinsville, OK 74021-1625 | 2017-08-30 |
| 1538400452 | North County Senior Living, LLC | Skilled Nursing Facility | 2300 W Broadway St, Collinsville, OK 74021-1625 | 2013-03-04 |
| 1770828295 | Leslyn Ann Sutton | Occupational Therapy Assistant | 2300 W Broadway St, Collinsville, OK 74021-1625 | 2012-12-10 |
| Find all providers in zip 74021 | ||||
| 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 |
|---|---|---|---|---|
| 1770013948 | Brandon Prior | Dentist | 1099 Belt Line Rd Ste J-k, Collinsville, IL 62234-4380 | 2017-06-19 |
| 1679925614 | Jaime Woodall | Dentist | 4721 Kings Mountain Rd, Collinsville, VA 24078-1274 | 2016-07-01 |
| 1770883688 | Collinsville Family Dental | Dentist | 9171 A, Old Hwy 19n, Collinsville, MS 39325 | 2010-10-26 |
| 1801932835 | Michael N Schaulat | Dentist | 308 West Clay Street, Collinsville, IL 62234 | 2007-01-29 |
| 1649322561 | Charles Seymour Borden IIi | Dentist | 724 Saint Louis Rd, Collinsville, IL 62234-2032 | 2007-01-18 |
| 1649372327 | Ronald A Zambaldi | Dentist | 3 Collinsport Dr, Collinsville, IL 62234 | 2006-09-02 |
| 1629080866 | Melissa Bowler | Dentist | 1310 W Main St, Collinsville, OK 74021-3012 | 2006-08-13 |
| 1205841939 | Denise J Unterbrink | Dentist | 2200 Daniels Creek Rd, Collinsville, VA 24078 | 2006-07-30 |
| 1912525205 | Jessica Khiet Quach | Dentist | 4940 Kings Mountain Rd, Collinsville, VA 24078-1812 | 2020-07-13 |
| 1306401591 | Signature Family Dental | Dentist | 1170 Belt Line Rd, Collinsville, IL 62234-4372 | 2019-05-03 |
| Find all providers in COLLINSVILLE | ||||
| City | COLLINSVILLE |
| Zip Code | 74021 |
Please comment or provide details below to improve the information on SPRING DENTAL COLLINSVILLE, PLLC.
| 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.