DR. SUSAN WELLER (NPI# 1740350529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740350529 |
| Entity Type | Individual |
| Full Name | DR. SUSAN WELLER |
| Credential | DMD |
| Practice Address |
1614 West Lafayette Avenue Jackson IL 62650 |
| Practice Telephone | 2172431114 |
| Practice Fax Number | 2172457906 |
| Mailing Telephone | 2172431114 |
| Mailing Fax Number | 2172457906 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 01918328 | IL | Dental Providers |
| Street Address |
1614 WEST LAFAYETTE AVENUE |
| City | JACKSON |
| State | IL |
| Zip Code | 62650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| 1205933561 | Wells Center Inc | Substance Abuse Rehabilitation Facility | 1300 Lincoln Avenue, Jacksonville, IL 62650 | 2006-09-20 |
| Find all providers in zip 62650 | ||||
| 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 |
|---|---|---|---|---|
| 1619595295 | Charles Austin Huffman | Dentist | 1189 E County Line Rd, Jackson, MS 39211-1836 | 2020-07-09 |
| 1184249278 | Sleep Better Solutions LLC | Dentist | 9 Chatwick Cv, Jackson, TN 38305-5642 | 2020-06-15 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1124689864 | Hannah Farrar | Dentist | 2064 S Highland Ave, Jackson, TN 38301-7741 | 2019-06-24 |
| 1417515214 | Richard Yoo | Dentist | 3857 Cooper St Ofc, Jackson, MI 49201-7547 | 2019-06-05 |
| 1487148078 | Tanvi Patil | Dentist | 1074 Jackson Crossing, Jackson, MI 49202-2039 | 2018-06-18 |
| 1487183737 | Arkady Khaykin | Dentist | 24 N Cooks Bridge Rd, Jackson, NJ 08527 | 2017-06-09 |
| 1497292239 | Advanced Dental Clinic | Dentist | 1555 E County Line Road, Jackson, MS 39211 | 2017-01-31 |
| 1598131336 | S Kaur Dds Inc | Dentist | 12120 Industry Blvd Ste 35, Jackson, CA 95642-9374 | 2015-08-17 |
| 1841675931 | Miriam Tygier Furlong | Dentist | 186 W Veterans Hwy, Jackson, NJ 08527-3410 | 2015-07-30 |
| Find all providers in JACKSON | ||||
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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.