Individual provider Active NPI

Jodie Coventry Jenkins, DDS

  • General Practice Dentistry
  • West Chester, OH
National Provider Identifier
1033258165
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
OH 30016431 Issued in OH
Practice address
7115 Hamilton Mason Rd
West Chester, OH 45069
Phone
(513) 755-2888
Fax
(513) 755-7444
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X OH 30016431 OH Primary

Addresses

Primary practice location

7115 Hamilton Mason Rd
West Chester, OH 45069

Mailing address

7115 Hamilton Mason Rd
West Chester, OH 45069
Phone (513) 755-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150327000386 OH Order and Referring Only - DentistPractitioner - Dentist 5496072662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OH 30016431OHMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033258165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7115 HAMILTON MASON RD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "45069",
            "telephone_number": "513-755-2888",
            "fax_number": "513-755-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7115 HAMILTON MASON RD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "45069",
            "telephone_number": "513-755-2888",
            "fax_number": "513-755-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "JODIE",
        "middle_name": "COVENTRY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "OH 30016431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

Verify at the official NPI Registry.