DR. JACK WILLIAM LEWIS (NPI# 1790780641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790780641 |
| Entity Type | Individual |
| Full Name | DR. JACK WILLIAM LEWIS |
| Credential | DDS |
| Practice Address |
3600 Caddo St Greenville TX 75401-4511 |
| Mailing Address |
4500 Wesley St Greenville TX 75401-5644 |
| Practice Telephone | 9034546965 |
| Practice Fax Number | 9034557981 |
| Mailing Telephone | 9034555986 |
| Mailing Fax Number | 9034544621 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2012-08-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
16437 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 007649901 | 05 | |
| TX | 009782601 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720479900 | Jack C Lewis Jr. | Counselor | 4120 Hackmore Loop, Irving, TX 75061 | 2015-02-10 |
| 1396013413 | Jack Covington Lewis | General Practice | 1100 Woodland Rd, Salisbury, MD 21801-6730 | 2011-12-03 |
| 1629399100 | Jack Bernard Lewis Jr. | Social Worker | 102 Landing Dr, Woodbury, NJ 08096-6845 | 2010-06-18 |
| 1881168789 | Jack Lewis | Student in an Organized Health Care Education/Training Program | 201 Reinhardt Dr, Lafayette, LA 70506-4252 | 2019-01-14 |
| 1568470433 | Jack Dennis Lewis | Dentist | 1770 E Lambert Rd, #220, Brea, CA 92821-8005 | 2006-08-04 |
| 1396706487 | Jack Byron Lewis | Urology | 1698 E Mcandrews Rd, Ste 280, Medford, OR 97504-5589 | 2006-03-29 |
| Street Address |
3600 CADDO ST |
| City | GREENVILLE |
| State | TX |
| Zip Code | 75401-4511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033557293 | Jennifer C Ezeh | Dentist | 3600 Caddo St, Greenville, TX 75401-4511 | 2013-06-10 |
| 1265879985 | Julianna Royston | Dentist | 3600 Caddo St, Greenville, TX 75401-4511 | 2013-06-04 |
| 1871844167 | Community Health Service Agency,inc | Dentist | 3600 Caddo St, Greenville, TX 75401-4511 | 2012-09-26 |
| 1740536739 | Mary Sarah Paulowsky Wildey | Dentist | 3600 Caddo St, Greenville, TX 75401-4511 | 2012-07-27 |
| 1083982920 | Carrie Beth Hartline | Dental Hygienist | 3600 Caddo St, Greenville, TX 75401-4511 | 2011-12-07 |
| 1174838064 | Doina Mihaela Charan | Dentist | 3600 Caddo St, Greenville, TX 75401-4511 | 2010-08-16 |
| 1598080269 | Lorenzo M Prats | Dentist | 3600 Caddo St, Greenville, TX 75401-4511 | 2010-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639653512 | Steven Wolanski | Occupational Therapy Assistant | Greenville Gardens Snf 3500 Park St., Greenville, TX 75401 | 2018-09-18 |
| 1184125460 | Heather Rae Hudson | Registered Nurse | 4911 Henry St, Greenville, TX 75401 | 2018-02-22 |
| 1154864742 | Kimberly Elaine Middleton | Nurse Practitioner | 4211 Joe Ramsey Blvd E Ste 105, Greenville, TX 75401 | 2016-11-30 |
| 1013373885 | Paul Brancheau | Podiatrist | 3900 Joe Ramsey Blvd E Bldg 5, Greenville, TX 75401 | 2016-01-11 |
| 1982079331 | Foresight Home Healthcare Incorporated | Home Health | 2102 Frazier Street, Greenville, TX 75401 | 2015-12-10 |
| 1083018451 | Johnny Sanders Jr. | Nurse's Aide | 1705 Northwest Hwy, Garland, TX 75401 | 2014-10-14 |
| 1942620299 | Robert Chandler Duckworth | Counselor | 4216 Wesley Street, Suite 700, Greenville, TX 75401 | 2014-04-24 |
| 1164843645 | Erica Rae Crawford | Psychologist | 3101 Joe Ramsey Boulevard, Suite 103a, Greenville, TX 75401 | 2013-12-30 |
| 1215225057 | Jordan Kelsi Mahan | Nurse Practitioner | 4101 Wesley St Ste D, Greenville, TX 75401 | 2011-07-14 |
| 1477888196 | Johnny Johnson | Physician Assistant | 4211 Joe Ramsey Blvd, Suite 100, Greenville, TX 75401 | 2009-10-14 |
| Find all providers in zip 75401 | ||||
| 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 |
|---|---|---|---|---|
| 1578184347 | Emily Brooke Wheeler Maltba | Dentist | 1105b Allen Ridge Dr, Greenville, NC 27834-0083 | 2020-05-02 |
| 1952937369 | Palms Dentistry 226 LLC | Dentist | 25 Innovation Dr # 100, Greenville, SC 29607-5252 | 2020-03-17 |
| 1053945964 | Huggins Dental LLC | Dentist | 407 Duncan Chapel Rd Ste B, Greenville, SC 29617-8224 | 2020-02-29 |
| 1578105482 | Star Bright Onsite, LLC | Dentist | 6709 White Horse Rd, Greenville, SC 29611-2503 | 2019-10-11 |
| 1053966408 | Maria Isabel Baltar De Barros Rego | Dentist | 1609 W Arlington Blvd Ste 107, Greenville, NC 27834-5610 | 2019-08-02 |
| 1366000739 | Andrew Joseph O'keefe | Dentist | 5076 Us Highway 264 E, Greenville, NC 27834-5804 | 2019-05-31 |
| 1811459159 | Southern Oak Dental, LLC | Dentist | 101 Verdae Blvd Ste 201, Greenville, SC 29607-3832 | 2019-04-04 |
| 1154889798 | Zachary Fox | Dentist | 1106 Woodruff Rd Ste A, Greenville, SC 29607-4109 | 2019-03-02 |
| 1366908238 | Joshua Lovick | Dentist | 3912 E 10th St, Greenville, NC 27858-8798 | 2019-02-15 |
| 1114497963 | Family Dental Health of Halton Road, LLC | Dentist | 155 Halton Village Cir Ste A, Greenville, SC 29607-6825 | 2018-12-04 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 75401 |
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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.