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).
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | Dental Providers |
| 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 |
| Street Address |
5205 E CORTLAND BLVD |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86004-9362 |
| 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 |
| Find all providers in zip 86004 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| 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. |
| 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 | ||||
Please comment or provide details below to improve the information on JERRY LEE COLLINS JR..
| 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.