Provider Demographics
NPI:1649428566
Name:MCALEVY, JARROD ROBERT (DDS)
Entity type:Individual
Prefix:
First Name:JARROD
Middle Name:ROBERT
Last Name:MCALEVY
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 1:121 BAYSIDE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-5986
Mailing Address - Country:US
Mailing Address - Phone:308-440-0274
Mailing Address - Fax:
Practice Address - Street 1:655 SOUTH 7TH STREET BLDG 700/700-A
Practice Address - Street 2:ROBINS AFB, GA
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:31098
Practice Address - Country:US
Practice Address - Phone:1478-327-8487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6772122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist