JERRY LEE COLLINS JR.


Address: 5205 E Cortland Blvd, Flagstaff, AZ 86004-9362
Phone: 5202306360

JERRY LEE COLLINS JR. (NPI# 1760096085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760096085
Entity Type Individual
Full Name JERRY LEE COLLINS JR.
Practice Address 5205 E Cortland Blvd
Flagstaff
AZ 86004-9362
Practice Telephone 5202306360
Mailing Telephone 5202306360
Enumeration Date 2020-09-03
Last Update Date 2020-09-03
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 124Q00000X Dental Hygienist Dental Providers

Other Providers JERRY COLLINS

NPI Name Taxonomy Address Enumeration
1073907804 Jerry Collins Counselor 5965 S 900 E, Murray, UT 84121-1720 2015-03-18
1164775268 Jerry Lynn Collins Pharmacist 902 S Main St, Sweetwater, TN 37874-1829 2012-10-26

Office Location

Street Address 5205 E CORTLAND BLVD
City FLAGSTAFF
State AZ
Zip Code 86004-9362

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598387805 Michael Joseph Oxtoby Counselor 2625 N. King St., Flagstaff, AZ 86004 2020-05-08
1083264501 Dazhoni Elizabeth Scott Counselor 1500 E. Cedar Avenue #26, 2110 N. East St Apt C, Flagstaff, AZ 86004 2019-09-17
1760948046 Emily Bauerle Social Worker 3009 N West St, Flagstaff, AZ 86004 2019-02-12
1992295745 Kaibab Behavioral Services, Pllc Behavioral Analyst 2323 E Greenlaw Lane, Suite 12a, Flagstaff, AZ 86004 2018-05-17
1083115364 Sequelcare of Arizona Community Based Residential Treatment Facility, Mental Illness 8800 Marys Drive, Flagstaff, AZ 86004 2018-02-22
1710391081 Janet Coleman Hearing Instrument Specialist 1851 E Butler Avenue, Flagstaff, AZ 86004 2014-06-16
1568703163 Mercy Timoh Pharmacist 4255 E. Soliere Ave., Flagstaff, AZ 86004 2013-03-06
1053617217 Scott Nichols Veterinarian 6122 Abineau Canyon Drive, Flagstaff, AZ 86004 2011-02-07
1366745218 Karoline S. Mariano Registered Nurse 3480 East Route 66, Flagstaff, AZ 86004 2010-12-15
1912209719 Payal Parekh Pharmacist 1500 E Cedar, Flagstaff, AZ 86004 2010-11-30
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Taxonomy Information

Taxonomy Code 124Q00000X
Grouping Dental Providers
Classification Dental Hygienist

Taxonomy Definition

An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary.
Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1417560608 Nicholette Congdon Dental Hygienist 208 E Knoles Drive, Flagstaff, AZ 86011-0001 2020-08-26
1093328437 Ryan M Fisher Dental Hygienist 3300 S Gila Dr Apt 1, Flagstaff, AZ 86005-6537 2020-08-25
1043479108 Fred Summerfelt Dental Hygienist 997 E Sterling Ln, Flagstaff, AZ 86001-6572 2008-06-04
1205433646 Alma Araiza Dental Hygienist 2920 N 4th St, Flagstaff, AZ 86004-1816 2020-10-08
1124639851 Cindy Barry Dental Hygienist 208 E Pine Knoll Dr, Flagstaff, AZ 86011-0001 2020-08-15
1326671595 Dana Michelle Morrison Dental Hygienist 2920 N 4th St, Flagstaff, AZ 86004-1816 2020-02-17
1376033944 Lydia Louise Cockayne Dental Hygienist 2920 N 4th St, Flagstaff, AZ 86004-1816 2018-05-18
1407380033 Shirl Simkins I Dental Hygienist 2920 N 4th St, Flagstaff, AZ 86004-1816 2017-04-20
1174071047 Kimberly Scott-freeman Dental Hygienist 2920 N 4th St, Flagstaff, AZ 86004-1816 2016-09-20
1831647999 Ryan Wood Dental Hygienist 2920 N 4th St, Flagstaff, AZ 86004-1816 2016-09-19
Find all providers in FLAGSTAFF

Competitor

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City FLAGSTAFF
Zip Code 86004

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Dataset Information

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.

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