Individual provider Active NPI

James Howard Tennyson, DDS

  • Dentist
  • Montgomery, AL
National Provider Identifier
1114986700
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D.0006718-C Issued in AL
Practice address
3439 McGehee Rd Ste 22
Montgomery, AL 36111-3392
Phone
(334) 288-1868
Fax
(334) 288-1825
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 004497 TN
Dentist 122300000X D.0006718-C AL Primary

Addresses

Primary practice location

3439 McGehee Rd Ste 22
Montgomery, AL 36111-3392

Mailing address

2424 Jefferson St SE
Roanoke, VA 24014-3312
Phone (540) 342-0276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220607001991 AL Order and Referring Only - DentistPractitioner - Dentist 4082092861

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D.0006718-CALMDDentist
004497TNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Dental Oral Health and Vision Center of Alabama, P.C. CurrentSince Jan 1, 2022 Accepting new patients
Advantage Dental Oral Health and Vision Center of Alabama, P.C. CurrentSince Jan 17, 2022 Accepting new patients

Locations

3439 McGehee Rd
Ste 22
Montgomery, AL 36111
Phone (334) 284-0228

3322 West End Ave
Ste 400
Nashville, TN 37203
Phone (629) 999-5014

Organizations & group practices 2

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1114986700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 JEFFERSON ST SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240143312",
            "telephone_number": "540-342-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3439 MCGEHEE RD STE 22",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361113392",
            "telephone_number": "334-288-1868",
            "fax_number": "334-288-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNYSON",
        "first_name": "JAMES",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "004497",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D.0006718-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.