Jenna L Gazzola, DMD, MA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D011690 Issued in AZ

Practice address

1175 W Wickenburg Way
Suite 1
Wickenburg, AZ 85390-2262

Phone

(928) 684-5475

NPI assigned

Oct 3, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• J & J Smiles

  • Dental Clinic/Center
  • Wickenburg, AZ
  • NPI 1699463497
  NPD Authorized official

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1104391341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 W WICKENBURG WAY",
            "address_2": "SUITE 1",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853902262",
            "telephone_number": "928-684-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 W WICKENBURG WAY",
            "address_2": "SUITE 1",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853902262",
            "telephone_number": "928-684-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZZOLA",
        "first_name": "JENNA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI2715600",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Marie Froelicher, MA LPC
• FSL Programs
• Alford Leon Garner Jr., PHARM D
• Gatehouse Therapeutic Health Services
• Laura Leigh Gates, LCSW
• Michaela Goering, DPT
• Kristin Gonzales
• Naomi Ruth Gregory, DC
• H & H Hospitalist PLLC
• Cami Hall

• General Practice Dentistry in Wickenburg, AZ
• Providers in Wickenburg, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.