Individual provider Active NPI

Jennifer Fernandez, D.M.D.

  • Dentist
  • Memphis, TN
National Provider Identifier
1043639651
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 21841 Issued in FL
Practice address
875 Union Ave
Memphis, TN 38103
Phone
(901) 448-6240
Fax
(901) 448-6249
NPI assigned
Apr 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 21841 FL Primary

Addresses

Primary practice location

875 Union Ave
Memphis, TN 38103

Mailing address

875 Union Ave
Memphis, TN 38103-3513
Phone (901) 448-6240

Other practice location 1

848 Adams Ave
Memphis, TN 38103-2816
Phone (901) 448-5437

Other practice location 2

875 Union Ave
Memphis, TN 38103
Phone (901) 448-6240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN 21841FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1043639651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033513",
            "telephone_number": "901-448-6240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38103",
            "telephone_number": "901-448-6240",
            "fax_number": "901-448-6249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "848 Adams Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032816",
            "country_code": "US",
            "telephone_number": "901-448-5437",
            "fax_number": "901-448-5438",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "875 Union Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "38103",
            "country_code": "US",
            "telephone_number": "901-448-6240",
            "fax_number": "901-448-6249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 21841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.