Jennifer M Fedon DDS PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JENNIFER M FEDON DDS PC

Practice address

5805 24 Mile Rd Ste a
Shelby Township, MI 48316-3281

Phone

(586) 604-5455

Fax

(586) 677-5567

NPI assigned

Jul 6, 2022

Last updated

Aug 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Marie Fedon, DDSNPI 1356579767

Title

Dentist

Phone

(586) 604-5455

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Marie Fedon, D.D.S

  • Dentist
  • Shelby TWP, MI
  • NPI 1356579767
  NPD Authorized official

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1033842281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 24 MILE RD STE A",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483163281",
            "telephone_number": "586-604-5455",
            "fax_number": "586-677-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5805 24 MILE RD STE A",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483163281",
            "telephone_number": "586-604-5455",
            "fax_number": "586-677-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER M FEDON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A",
        "authorized_official_last_name": "FEDON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "586-604-5455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "F350398585901",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Jaques
• Angela Maher Jaro
• Jennifer A Jarzombek, OTR
• Alyssa Jaworski, FNP-BC
• Nancy Ilene Jayroe, M.A., LPC., NCC
• Venessa Lola-May Jennings
• Tammie Lynne Jensen, MA-CCC-SLP
• Kelsey Joa
• Alexa Joh
• John R Fow III DO PC

• Dental Clinic/Center in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.