Dr. Jerad Chance Divine is a Wichita, Kansas based Dentist who is specialized in General Practice Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Jerad Chance Divine is 61283 for Endodontics in Kansas. His current practice location is 12219 E Central Ave, Wichita. Patients can reach him at 316-681-1099.
Dr. Jerad Chance Divine is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Dr. Jerad Chance Divine speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Dr. Jerad Chance Divine
Specialization:
Dentist
Gender:
Male
Credentials:
D.D.S.
Accepts Medicare Assignment:
No
Practice Address:
12219 E Central Ave, Wichita, Kansas, 67206-2808
Phone:
316-681-1099
Fax:
316-613-2417
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1841587250
NPI Enumeration Date:
06 Jul, 2011
NPI Last Update On:
12 Dec, 2022
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Jerad Chance Divine are as mentioned below.
License Number
Specialization
State
Status
61283
Endodontics
Kansas
Primary
2011014424
General Practice Dentistry
Missouri
Secondary
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Jerad Chance Divine such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
2011014424
Other
Missouri
DENTAL LICENSE
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
12219 E Central Ave, Wichita, Kansas
Zip:
67206-2808
Phone Number:
316-681-1099
Fax Number:
316-613-2417
Patients can reach Dr. Jerad Chance Divine at 12219 E Central Ave, Wichita, Kansas or can call to book an appointment on 316-681-1099. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 November, 2024.