Jennifer Dahae Ahn, DMD
Individual provider Active NPI Dentist · Montgomery, AL
NPI 1073937488 · NPPES record last updated Dec 9, 2014
Key facts
- NPI
- 1073937488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6075 (AL)
- Practice address
- 2201 Taylor Rd
Montgomery, AL 36117-3498 - Phone
- (334) 271-4600
- NPI assigned
- Feb 6, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150408001437 | AL | Order and Referring Only - Dentist |
6901124775 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6075 | AL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Taylor Dental PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6075 | AL | Yes |
Addresses
Primary practice location
2201 Taylor Rd
Montgomery, AL 36117-3498
Mailing address
2201 Taylor Rd
Montgomery, AL 36117-3498
Phone (334) 271-4600
Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.