Brent W Pennington, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012927 Issued in GA

Practice address

37 Gateway Business Park Dr
Ringgold, GA 30736-7395

Phone

(706) 935-2900

Fax

(706) 935-2904

NPI assigned

Oct 6, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Brent Pennington DMD,LLC

  • Dental Clinic/Center
  • Ringgold, GA
  • NPI 1417054784
  NPD (past) Authorized official

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223251200000",
    "number": "1144471400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 GATEWAY BUSINESS PARK DR",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307367395",
            "telephone_number": "706-935-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 GATEWAY BUSINESS PARK DR",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307367395",
            "telephone_number": "706-935-2900",
            "fax_number": "706-935-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "BRENT",
        "middle_name": "W",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-06",
        "last_updated": "2008-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "484260991C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paxton Family Chiropractic, Inc.
• Joshua Daniel Paxton, D.C.
• Hayley Payne
• Kristen Payne, RN
• Thomas William Pedersen, PSY.D.
• Rachel Perkins, LPN
• Dejion Michelle Person, LPN
• Jaime Elaine Pesl, NP-C
• Caylie Peters
• Dawn Michele Pettigrew, LPN

• General Practice Dentistry in Ringgold, GA
• Providers in Ringgold, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; 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.