Individual provider Active NPI

Jennette Marie Bick, DDS

  • Periodontics
  • Winchester, VA
National Provider Identifier
1073893137
Registry record updated Feb 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
0401413196 Issued in VA
Practice address
1805 Plaza Dr
Winchester, VA 22601-6365
Phone
(540) 535-0401
NPI assigned
Aug 22, 2011
Last updated
Feb 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 0401413196 VA Primary

Addresses

Primary practice location

1805 Plaza Dr
Winchester, VA 22601-6365

Mailing address

1805 Plaza Dr
Winchester, VA 22601-6365
Phone (540) 535-0401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 25, 2026 through Jun 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401413196VAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Brandon Coleman, DDS, PLLC Periodontics CurrentSince Jun 23, 2025 Accepting new patients

Locations

1805 Plaza Dr
Winchester, VA 22601
Phone (540) 535-0401

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738454400000",
    "number": "1073893137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 PLAZA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016365",
            "telephone_number": "540-535-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 PLAZA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016365",
            "telephone_number": "540-535-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICK",
        "first_name": "JENNETTE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2025-02-02",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401413196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.