DR. JUAN KEVIN PACKER


Address: 100 S Bliss Ave, Tahlequah, OK 74464-2512
Phone: 9184583150

DR. JUAN KEVIN PACKER (NPI# 1881610855) 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) 1881610855
Entity Type Individual
Full Name DR. JUAN KEVIN PACKER
Credential D.M.D.
Practice Address 100 S Bliss Ave
Tahlequah
OK 74464-2512
Mailing Address 2020 Aspen Dr
Tahlequah
OK 74464-6035
Practice Telephone 9184583150
Mailing Telephone 9184585549
Enumeration Date 2006-07-14
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223D0001X Dentist
Specialization: Dental Public Health
3046-98 MS Dental Providers

Office Location

Street Address 100 S BLISS AVE
City TAHLEQUAH
State OK
Zip Code 74464-2512

Providers in the same location

NPI Name Taxonomy Address Enumeration
1194727198 Owen Buck Gilmore Family Medicine 100 S Bliss Ave, Tahlequah, OK 74464-2512 2005-08-10
1669085049 Catherine Bailey Mcguffey Physician Assistant 100 S Bliss Ave, Tahlequah, OK 74464-2512 2020-08-26
1679183404 Kathryn Nicole Martin Advanced Practice Midwife 100 S Bliss Ave, Tahlequah, OK 74464-2512 2020-08-06
1548882103 Stacy Lynn Rutherford Registered Nurse 100 S Bliss Ave, Tahlequah, OK 74464-2512 2020-05-17
1033739354 Kelsey Kitchens Audiologist 100 S Bliss Ave, Tahlequah, OK 74464-2512 2020-04-17
1952930257 Athena Chatzigiannidis Student in an Organized Health Care Education/Training Program 100 S Bliss Ave, Tahlequah, OK 74464-2512 2020-04-07
1942839394 Sean Crawford Student in an Organized Health Care Education/Training Program 100 S Bliss Ave, Tahlequah, OK 74464-2512 2020-04-07
1912544735 Henri Jade Casey Dentist 100 S Bliss Ave, Tahlequah, OK 74464-2512 2019-12-01
1831743624 Sonny Jefferson James Downing Pharmacist 100 S Bliss Ave, Tahlequah, OK 74464-2512 2019-07-30
1275190688 Sam Blake Campbell Dentist 100 S Bliss Ave, Tahlequah, OK 74464-2512 2019-05-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184253403 Kendall Harris Student in an Organized Health Care Education/Training Program 100 Bliss Ave, Tahlequah, OK 74464 2020-04-07
1528609302 Norma Brightly Technician 103 Sequoyah, Tahlequah, OK 74464 2019-10-03
1073175832 Jody Lynn Dallis Case Manager/Care Coordinator Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 2019-07-02
1184287849 Perry Jake Proctor Student in an Organized Health Care Education/Training Program 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 2019-04-18
1336657279 Sidney Sheyenne Kimble Case Manager/Care Coordinator 1429 Jack Brown Lane, Tahlequah, OK 74464 2018-01-12
1891225686 Nichols Bradley Alberty Orthotist 1294 East Downing, Suite 3, Tahlequah, OK 74464 2017-06-14
1922549690 Krystal Easter Ms, Lpc Counselor 2201 Oakridge Dr, Tahlequah, OK 74464 2017-03-15
1144777319 Northeastern Oklahoma Community Health Centers, Inc. Clinic/Center 529 N. Oak St., Tahlequah, OK 74464 2016-09-06
1548713456 Clement Isioma Nwadozi Optometrist 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 2016-07-27
1033532635 Wesley Gragg Specialist/Technologist 603 North Grand Avenue, Tahlequah, OK 74464 2014-02-03
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Taxonomy Information

Taxonomy Code 1223D0001X
Grouping Dental Providers
Classification Dentist
Specialization Dental Public Health

Taxonomy Definition

The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689929184 Ronald Faram Dentist 100 S Bliss Ave, Tahlequah, OK 74464-2512 2012-07-20

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1144507781 Dr.s Lowe, Nguyen & Do Dentist 4157 S Harvard Ave Ste 119, Tulsa, OK 74135-2606 2011-11-10
1033440649 Shina Odejimi Dentist 201 E Parker Mckenzie Dr, Anadarko, OK 73005-0828 2010-01-21
1366677601 Vicki Harless Dentist 440 S Houston Ave, Suite 402, Tulsa, OK 74127-8903 2009-05-15
1497860175 Dennis W Harris Dentist 1213 Sw 89th St, Suite B, Oklahoma City, OK 73139-9111 2006-08-20
1639186729 Leon Douglas Bragg Sr. Dentist 1321 Ne 54th St, Oklahoma City, OK 73111-6611 2006-08-01
1194766188 John R. Mcdavid Dentist 3919 N Macarthur Blvd, Warr Acres, OK 73122-2005 2006-06-09
1700871779 Micah J Bevins Dentist 6349 S Memorial Dr, Suite B, Tulsa, OK 74133-1940 2005-09-15
1134126980 Brandon Royal Bowers Dentist 1414 N Kennedy St, Ste 101, Shawnee, OK 74801 2005-07-07
1679052856 Hayley Beth Shenberger Dentist 1001 S 41st St E, Muskogee, OK 74403-6253 2018-08-09
1518443738 Deandra Hayes Dentist 1001 S 41st St E, Muskogee, OK 74403-6253 2018-07-11
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Competitor

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City TAHLEQUAH
Zip Code 74464

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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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