Jerry Jack, DDS - Dentist in Moore, OK

Jerry Jack, DDS is a Dentist - General Practice based in Moore, Oklahoma. Jerry Jack is licensed to practice in Oklahoma (license number 3903) and his current practice location is 1740 N Service Rd, Moore, Oklahoma. He can be reached at his office (for appointments etc.) via phone at (405) 794-7200.

NPI number for Jerry Jack is 1265463467 and his current mailing address is 555 W Benjamin Holt Dr, Building B, Stockton, California. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1265463467.

Contact Information

Jerry Jack, DDS
1740 N Service Rd,
Moore, OK 73160-3307
(405) 794-7200
(405) 794-2266



Healthcare Provider's Profile

Full NameJerry Jack
GenderMale
SpecialityDentist - General Practice
Location1740 N Service Rd, Moore, Oklahoma
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1265463467
  • Provider Enumeration Date: 07/05/2006
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Jerry Jack such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1265463467NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223G0001XDentist - General Practice 3903 (Oklahoma)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jerry Jack is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jerry Jack, DDS
555 W Benjamin Holt Dr, Building B,
Stockton, CA 95207-3839

Ph: (209) 476-4700
Jerry Jack, DDS
1740 N Service Rd,
Moore, OK 73160-3307

Ph: (405) 794-7200

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› Verified 3 days ago


Dentist in Moore, OK

Dr. Leta Langford, DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 2305 S I-35, Moore, OK 73160
Phone: 405-799-7529    Fax: 405-799-0802
Dr. Chad Douglas Spiva, DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 808 Ne 19th St, Moore, OK 73160
Phone: 405-799-5529    Fax: 405-799-8223
Jimmy J Richardson, DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 840 Se 4th St, Suite 3a, Moore, OK 73160
Phone: 405-799-7071    Fax: 405-794-5597
Mattie Elizabeth Eddleman,
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 780 Sw 19th St, Moore, OK 73160
Phone: 402-669-2590    
Dr. James Allen Hulsey, DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 2709 S I 35 Service Rd Ste B, Moore, OK 73160
Phone: 405-237-4979    
Mr. Richard Murry Freeman, DDS
Dentist
Medicare: Medicare Enrolled
Practice Location: 500 N Eastern Ave, Moore, OK 73160
Phone: 405-912-3300    Fax: 405-912-2278
Dallin Bryan Harris, DMD
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 811 Sw 19th St Ste A, Moore, OK 73160
Phone: 405-703-5161    

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