PRITCHARD JASTREMSKI DENTAL ASSOC. LLC (NPI# 1639291958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639291958 |
| Entity Type | Organization |
| Organization Name | PRITCHARD JASTREMSKI DENTAL ASSOC. LLC |
| Practice Address |
1550 S Liberty Dr Bloomington IN 47403-5167 |
| Practice Telephone | 8123392811 |
| Practice Fax Number | 8129610746 |
| Mailing Telephone | 8123392811 |
| Mailing Fax Number | 8129610746 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KELLY ANDREW JASTREMSKI (OWNER MANAGER) |
| Authorized Official Telephone | 8123392811 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
12009671 | IN | Dental Providers |
| Street Address |
1550 S LIBERTY DR |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47403-5167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023670890 | Elizabeth Huck | Dentist | 1550 S Liberty Dr, Bloomington, IN 47403-5167 | 2019-07-02 |
| 1881819423 | Gavin Charles Rothrock | Dentist | 1550 S Liberty Dr, Bloomington, IN 47403-5167 | 2007-04-17 |
| 1639291925 | Stephen Jay Pritchard | Dentist | 1550 S Liberty Dr, Bloomington, IN 47403-5167 | 2007-04-06 |
| 1215059514 | Kelly Andrew Jastremski | Dentist | 1550 S Liberty Dr, Bloomington, IN 47403-5167 | 2007-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
| 1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
| 1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
| 1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
| 1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
| 1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
| 1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
| 1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
| 1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
| 1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
| Find all providers in zip 47403 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972162527 | Pournawattie Andrea Chandradatt | Dentist | 7936 Portland Ave S, Bloomington, MN 55420-1315 | 2019-06-07 |
| 1336601756 | Neha Shah | Dentist | 17644 Valley Blvd Ste 1, Bloomington, CA 92316-3908 | 2019-04-03 |
| 1033689054 | Erick Esmenjaud D.d.s. Inc | Dentist | 18793 Valley Blvd Ste A-b, Bloomington, CA 92316-2253 | 2018-12-03 |
| 1336620160 | Mohamed Owais Sultan | Dentist | 857 S Auto Mall Rd Ste 4, Bloomington, IN 47401-5488 | 2018-08-29 |
| 1285184259 | Children's Center for Dentistry | Dentist | 2111 E Oakland Ave Ste C, Bloomington, IL 61701-5783 | 2016-10-13 |
| 1255783320 | Fatima Quadri | Dentist | 401 N Veterans Pkwy, Unit D, Bloomington, IL 61704-3550 | 2016-07-12 |
| 1528419686 | Brandt Allen Finney | Dentist | 2909 E Buick Cadillac Blvd, Bloomington, IN 47401-5443 | 2016-06-29 |
| 1942668702 | Point Family Dentistry | Dentist | 10611 France Ave S Ste 201, Bloomington, MN 55431-3554 | 2016-02-08 |
| 1710344494 | Bloomington Smiles Dentistry, PC | Dentist | 10700 France Avenue, Suite 102, Bloomington, MN 55437 | 2016-01-26 |
| 1497160204 | Jp Dental - Bloomington, LLC | Dentist | 409 S Dunn St, Bloomington, IN 47401-4822 | 2014-07-01 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47403 |
Please comment or provide details below to improve the information on PRITCHARD JASTREMSKI DENTAL ASSOC. LLC.
| 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.