Jennifer C Ezeh, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28921 Issued in TX

Practice address

3600 Caddo St
Greenville, TX 75401-4511

Phone

(903) 454-6965

Fax

(903) 454-7981

NPI assigned

Jun 10, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Health Service Agency, Inc.

  • Federally Qualified Health Center (FQHC)
  • Greenville, TX
  • NPI 1871844167

  General Practice

  NPD (past)

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1033557293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1908",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754031908",
            "telephone_number": "903-454-3025",
            "fax_number": "903-450-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 CADDO ST",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754014511",
            "telephone_number": "903-454-6965",
            "fax_number": "903-454-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEH",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-10",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Equate Global Services, Inc
• Europa Enterprise LLC
• Austine Mae Villaronte Evangelista, PT
• Gary Randall Evans, DDS
• Eyemart Express LLC
• Ehab M Faheid, M. D.
• Family Dental Group of Greenville PLLC
• Family First Home Health and Hospice, LLC
• Family First Home Health, LLC
• Family First Non-Emergency Medical Transportation, LLC

• General Practice Dentistry in Greenville, TX
• Providers in Greenville, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.