DR. JOHN C TACKETT (NPI# 1578666426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578666426 |
| Entity Type | Individual |
| Full Name | DR. JOHN C TACKETT |
| Credential | DMD |
| Practice Address |
102 N Harrison St Salem IN 47167-1426 |
| Practice Telephone | 8128834281 |
| Practice Fax Number | 8128834289 |
| Mailing Telephone | 8128834281 |
| Mailing Fax Number | 8128834289 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
12009512A | IN | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538481536 | John Dewey Tackett | Counselor | 1817 Sawmill Pl, Mansfield, OH 44904-1713 | 2010-02-18 |
| 1346532124 | John Joseph Tackett | Surgery | 5 E 98th St # 1259, New York, NY 10029-6501 | 2011-05-11 |
| 1740472018 | John T Tackett | Pharmacist | 8050 Highway 72 W, Madison, AL 35758-9567 | 2007-08-10 |
| Street Address |
102 N HARRISON ST |
| City | SALEM |
| State | IN |
| Zip Code | 47167-1426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679951792 | Forefront Dermatology, S.c. | Dermatology | 911 N Shelby Street, St. Vincent Salem Hospital, Specialty Clinic, Salem, IN 47167 | 2015-05-08 |
| 1407188162 | Sheila Belamour | Physical Therapy Assistant | 900 Anson Street, Salem, IN 47167 | 2010-02-05 |
| 1598988834 | Blue River Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 118 N. Nichols Ave., Salem, IN 47167 | 2007-04-11 |
| 1740303973 | Blue River Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 75 E. Oak Dr, Salem, IN 47167 | 2007-04-10 |
| 1689709594 | Renal Treatment Centers Illinois Inc | Clinic/Center | 1201 N Jim Day Road, Ste 103, Salem, IN 47167 | 2007-02-22 |
| 1780738161 | Martin F Kennedy Dds PC | Dentist | 1600 S State Rd 135, Salem, IN 47167 | 2007-01-22 |
| 1114079449 | Gene F Hedrick Dds PC | Dentist | 100 North Harrison Street, Salem, IN 47167 | 2007-01-17 |
| 1689626038 | Kristen Ingram | Family Medicine | 1002 N Shelby St Ste 1004, Salem, IN 47167 | 2006-05-16 |
| 1952825564 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 803 S Main St, Salem, IN 47167 | 2017-07-26 |
| 1558770370 | Ashlee Austin | Occupational Therapist | 900 Anson St, Salem, IN 47167 | 2014-08-06 |
| Find all providers in zip 47167 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831686468 | Jev A. Clark, Dmd, Md, LLC | Dentist | 120 Ramsgate Sq S Ste 110, Salem, OR 97302-5870 | 2018-04-19 |
| 1164712022 | Travis Jon Hamilton | Dentist | 250 Church St Se Ste 102, Salem, OR 97301-3758 | 2011-04-12 |
| 1124242813 | Dennis Douglas Johnson | Dentist | 410 Lancaster Dr Ne, Suite A, Salem, OR 97301-4794 | 2007-04-12 |
| 1407981855 | George Michael Koumaras | Dentist | 143 Bogey Ln, Salem, VA 24153-6858 | 2007-02-23 |
| 1609878172 | James M. Eyre Jr. | Dentist | 250 Church St Se, Ste 102, Salem, OR 97301-8500 | 2005-08-13 |
| 1588665723 | David Wesley Howerton | Dentist | 2266 Mission St Se, Salem, OR 97302-1267 | 2005-08-10 |
| 1447258223 | Gary Theodore Pederson | Dentist | 1565 Liberty St Se, Salem, OR 97302-4345 | 2005-07-14 |
| 1174520548 | Martin J. Mehr | Dentist | 120 Ramsgate Sq S, Suite 110, Salem, OR 97302-5868 | 2005-06-30 |
| 1972996197 | Southwest Virginia Oral & Maxillofacial Surgery, Pllc | Dentist | 1940 Braeburn Dr, Suite A, Salem, VA 24153-7383 | 2015-03-12 |
| 1386041358 | Erda Carmel Pradel | Dentist | 3490 Lancaster Dr Ne, Salem, OR 97305-1356 | 2014-11-19 |
| Find all providers in SALEM | ||||
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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.