# DR. JEREMY LEWIS EGAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1225561061
- **Gender:** Man
- **Credential:** DMD, MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7760 | OK | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2024047374 | MO | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 234 | OK | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | — |

## Other

- **Enumeration date:** 04/08/2017
- **Last updated:** 01/20/2025