Jerry D Snell II, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

OK5496 Issued in OK

Practice address

26245 Highway 82 Ste 2
Park Hill, OK 74451-2802

Phone

(918) 458-5140

Fax

(918) 458-5155

NPI assigned

Dec 21, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Keys Family Dentistry

  • General Practice Dentistry
  • Park Hill, OK
  • NPI 1801047725
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720142060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26245 HIGHWAY 82 STE 2",
            "city": "PARK HILL",
            "state": "OK",
            "postal_code": "744512802",
            "telephone_number": "918-458-5140",
            "fax_number": "918-458-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26245 HIGHWAY 82 STE 2",
            "city": "PARK HILL",
            "state": "OK",
            "postal_code": "744512802",
            "telephone_number": "918-458-5140",
            "fax_number": "918-458-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNELL",
        "first_name": "JERRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "OK5496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maggie A. Pack, D.C.
• Michele Jeanene Reeves, RN
• Kylee Shae Russell
• Julie M Schaefer
• Tamey Lyn Simmons
• T. E. Trow, M.D., P.L.L.C.
• Debra Teague
• Thomas E Trow
• Sasha Wyatt, M.S., CCC-SLP

• General Practice Dentistry in Park Hill, OK
• Providers in Park Hill, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.