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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223D0001X |
Dentist Specialization: Dental Public Health |
3046-98 | MS | Dental Providers |
Street Address |
100 S BLISS AVE |
City | TAHLEQUAH |
State | OK |
Zip Code | 74464-2512 |
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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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 Code | 1223D0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Dental Public Health |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689929184 | Ronald Faram | Dentist | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2012-07-20 |
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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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.