JARED WILSON BRISTOL (NPI# 1962917575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962917575 |
| Entity Type | Individual |
| Full Name | JARED WILSON BRISTOL |
| Practice Address |
573 Concord Rd Se Ste C Smyrna GA 30082-2611 |
| Practice Telephone | 7704359046 |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2017-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DN015049 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | DENTAL LICENSE | DN015049 | 01 |
| Street Address |
573 CONCORD RD SE STE C |
| City | SMYRNA |
| State | GA |
| Zip Code | 30082-2611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952816373 | Jennings W Bristol Dds PC | Dentist | 573 Concord Rd Se Ste C, Smyrna, GA 30082-2611 | 2017-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528600335 | Arden Constance Mobley | Occupational Therapist | 3200 Highlands Parkway Suite 150, Smyrna, GA 30082 | 2019-10-14 |
| 1386185916 | Nicholas Andrews | Behavior Technician | 5034 Laurel Bridge, Smyrna, GA 30082 | 2017-03-15 |
| 1518331362 | Shannon Wilkerson | Counselor | 3040 Highlands Pkwy, Ste G, Smyrna, GA 30082 | 2015-11-17 |
| 1235529611 | Frances Offiah Idowu | Nurse Practitioner | 3240 South Cobb Drive, Smyrna, GA 30082 | 2015-01-23 |
| 1053717850 | Deena Altman Spital | Physician Assistant | 400 Technology Ct, Suite J, Smyrna, GA 30082 | 2014-11-06 |
| 1487964193 | Revive Athletics, Inc | Counselor | 460 Bourne Drive, Smyrna, GA 30082 | 2010-10-15 |
| 1386956746 | Kalpit C Patel | Family Medicine | 4480 N Cooper Lake Rd Se Ste 100, Smyrna, GA 30082 | 2010-07-13 |
| 1285826800 | David Goziem Nwabunor | Emergency Medicine | 415 Oak Brook Ct Se, Smyrna, GA 30082 | 2007-08-16 |
| 1437357373 | Amit M Patel | Plastic Surgery | 3968 Felton Hill Rd Sw, Ste 100, Smyrna, GA 30082 | 2007-07-03 |
| 1225103849 | Daniel C Norris Dds PC | Dentist | 620 Concord Rd, Smyrna, GA 30082 | 2006-11-21 |
| Find all providers in zip 30082 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174052245 | Stacey Elise Reich | Dentist | 4849 S Cobb Dr Se Ste 111, Smyrna, GA 30080-7145 | 2017-06-12 |
| 1114464062 | Signature Smiles Family Dentistry | Dentist | 1932 Almaville Rd, Suite 105, Smyrna, TN 37167-4404 | 2017-01-30 |
| 1669840211 | Smyrna Modern Dentistry, PC | Dentist | 160 Movie Row, Smyrna, TN 37167 | 2015-09-11 |
| 1205210911 | Richard Anderson | Dentist | 840 Nissan Dr., Smyrna, TN 37167 | 2015-07-13 |
| 1003305251 | Hannah Isabel Alexander | Dentist | 4500 W Village Pl Se Unit 2015, Smyrna, GA 30080-9245 | 2013-08-24 |
| 1407102015 | Daniel C. Norris | Dentist | 620 Concord Rd Se, Smyrna, GA 30082-2619 | 2012-08-01 |
| 1801184478 | Sara Twardy | Dentist | 1060 Windy Hill Road Se, Suite 220, Smyrna, GA 30080 | 2011-07-18 |
| 1184920985 | Integrity Dental Care, Pllc | Dentist | 301 Wolverine Trl Ste 203, Smyrna, TN 37167-5656 | 2011-01-27 |
| 1962716472 | Cheryl R Coggins | Dentist | 440 Sam Ridley Pkwy W Ste 140, Smyrna, TN 37167-2999 | 2010-07-27 |
| 1548415771 | Susan F. Wilborn-hood | Dentist | 436 Tioram Ln Se, Smyrna, GA 30082-5239 | 2008-12-02 |
| Find all providers in SMYRNA | ||||
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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.