Individual provider Active NPI

Jennifer L. Zoll, D.D.S.

  • Pediatric Dentistry
  • Toledo, OH
National Provider Identifier
1083610463
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
18423 Issued in OH
Practice address
3036 W Sylvania Ave
Toledo, OH 43613-4128
Phone
(419) 474-0733
Fax
(419) 474-5407
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 18423 OH Primary

Addresses

Primary practice location

3036 W Sylvania Ave
Toledo, OH 43613-4128

Mailing address

3036 W Sylvania Ave
Toledo, OH 43613-4128
Phone (419) 474-0733

Other identifiers 2

IdentifierTypeStateIssuer
341817921OtherOHFED TAX ID
0701520MedicaidOH

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
18423OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer L Zoll, DDS, LLC Pediatric Dentistry Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1083610463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3036 W SYLVANIA AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436134128",
            "telephone_number": "419-474-0733",
            "fax_number": "419-474-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3036 W SYLVANIA AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436134128",
            "telephone_number": "419-474-0733",
            "fax_number": "419-474-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLL",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "18423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED TAX ID",
            "identifier": "341817921",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0701520",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.