NPIMap

Organization Active NPI

Jennifer Datwyler, DMD, Inc

  • Pediatric Dentistry
  • El Dorado Hills, CA
National Provider Identifier
1043370448
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
42679 Issued in CA
Legal business name
JENNIFER DATWYLER, DMD, INC
Practice address
5009 Windplay Dr
Suite 1
El Dorado Hills, CA 95762
Phone
(916) 941-2366
Fax
(916) 941-1443
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Authorized official

Name
Dr. Jennifer R Datwyler, DMDNPI 1831287796
Title
President
Phone
(916) 941-2341

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 42679 CA Primary

Addresses

Primary practice location

5009 Windplay Dr
Suite 1
El Dorado Hills, CA 95762

Mailing address

5009 Windplay Dr
Suite 1
El Dorado Hills, CA 95762
Phone (916) 941-2341

Other names 1

  • Magic Smiles Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

5009 Windplay Dr
Ste 1
El Dorado Hills, CA 95762
Phone (916) 941-2341

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1043370448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5009 WINDPLAY DR",
            "address_2": "SUITE 1",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "95762",
            "telephone_number": "916-941-2341",
            "fax_number": "916-941-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5009 WINDPLAY DR",
            "address_2": "SUITE 1",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "95762",
            "telephone_number": "916-941-2366",
            "fax_number": "916-941-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER DATWYLER, DMD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "DATWYLER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-941-2341",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "42679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magic Smiles Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magic Smiles Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Dorado Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.