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Dr. Jerad Chance Divine, DDS
Endodontist in Wichita, Kansas
NPI 1841587250

Jerad Chance Divine is a Endodontist based in Wichita, KS and is specialized in Endodontics. Jerad Chance Divine practices in Wichita, KS and has the professional credentials of DDS. The NPI Number for Jerad Chance Divine is 1841587250 and holds a License No. 2011014424 (Kansas).

The current practice location address for Jerad Chance Divine is 12219 E Central Ave, Wichita, KS and can be reached out via phone at 316-681-1099 and via fax at 316-613-2417.

Location: 12219 E Central Ave, Wichita, KS, 67206-2808
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1841587250
Provider Name
Jerad Chance Divine
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
12219 E Central Ave, Wichita, KS, 67206-2808
Phone Number
316-681-1099
Fax Number
316-613-2417
Provider Enumeration Date
07/06/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2011014424 01 MO DENTAL LICENSE
institution
Provider Business Practice Location Address Details
Address
12219 E Central Ave
City
Wichita
State
Kansas
Zip
67206-2808
Phone Number
316-681-1099
Fax Number
316-613-2417
person
Provider Business Mailing Address Details
Address
12219 E Central Ave
City
Wichita
State
Kansas
Zip
67206-2808
Phone Number
316-681-1099
Fax Number
316-613-2417
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Endodontics
Taxonomy
1223E0200X
License No.
61283 (Kansas)
Definition
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
2011014424 (Missouri)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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