Active NPI
James Howard Tennyson, DDS
- Dentist
- Montgomery, AL
National Provider Identifier
1114986700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D.0006718-C
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220607001991 | AL | Order and Referring Only - Dentist | 4082092861 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D.0006718-C | AL | MD | Dentist |
| 004497 | TN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advantage Dental Oral Health and Vision Center of Alabama, P.C. | Current | Accepting new patients | |
| Advantage Dental Oral Health and Vision Center of Alabama, P.C. | Current | 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.
-
- Optometrist
- Montgomery, AL
- NPI 1801372958
-
- Pediatric Dentistry
- Montgomery, AL
- NPI 1942614417
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.