JERGER PEDIATRIC DENTISTRY, PC (NPI# 1952791006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952791006 |
| Entity Type | Organization |
| Organization Name | JERGER PEDIATRIC DENTISTRY, PC |
| Practice Address |
2101 N Main St Decatur IL 62526-4375 |
| Practice Telephone | 2178753080 |
| Practice Fax Number | 2178753084 |
| Mailing Telephone | 2178753080 |
| Mailing Fax Number | 2178753084 |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2015-01-28 |
| Authorized Official Name | DR. BRET M JERGER (OWNER) |
| Authorized Official Telephone | 2178753080 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
021001772 | IL | Dental Providers |
| Street Address |
2101 N MAIN ST |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-4375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245323302 | Bret M Jerger | Dentist | 2101 N Main St, Decatur, IL 62526-4375 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639441876 | Walter Ray Davis Jr. | Dentist | 1270 Mcconnell Dr Ste B, Decatur, GA 30033-3507 | 2012-02-03 |
| 1639201700 | Harry Patrick Stanley | Dentist | 1304 14th Ave Se, Decatur, AL 35601-4315 | 2007-03-12 |
| 1760524086 | Ulpa Patel | Dentist | 2637 N Decatur Rd, Decatur, GA 30033-6103 | 2007-02-13 |
| 1083793533 | Joel Allen Hardin | Dentist | 2426 Danville Rd Sw, Suite Q, Decatur, AL 35603-4293 | 2006-11-03 |
| 1427011253 | Wayne R Miller | Dentist | 2855 Candler Rd, Suite 10, Decatur, GA 30034-1415 | 2006-04-11 |
| 1912549759 | James Franklin Campbell IIi | Dentist | 1815 Somerville Rd Se, Decatur, AL 35601-5015 | 2019-10-14 |
| 1114057262 | Carolyn W Williams | Dentist | 5000 Snapfinger Woods Dr, Suite B-210, Decatur, GA 30035-4085 | 2007-03-07 |
| 1245323302 | Bret M Jerger | Dentist | 2101 N Main St, Decatur, IL 62526-4375 | 2006-10-02 |
| 1962412619 | Allen D Mccaghren | Dentist | 1823 Somerville Rd Se, Decatur, AL 35601-5015 | 2006-08-08 |
| 1932157690 | Rebecca Lynn Barkley | Dentist | 755 Commerce Dr, Ste 712, Decatur, GA 30030 | 2006-05-05 |
| Find all providers in DECATUR | ||||
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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.