Provider Demographics
NPI:1568479004
Name:COX, JARED EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:EDWARD
Last Name:COX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S MAIN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-6848
Mailing Address - Country:US
Mailing Address - Phone:501-268-3223
Mailing Address - Fax:501-268-4243
Practice Address - Street 1:400 S MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6848
Practice Address - Country:US
Practice Address - Phone:501-268-3223
Practice Address - Fax:501-268-4243
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR33901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X980OtherBCBS PROVIDER ID