Active NPI
Eleonora Jenkins, D.M.D
- General Practice Dentistry
- Hephzibah, GA
National Provider Identifier
1154423390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN013334
- Practice address
- 2636 Tobacco Rd
Suite a
Hephzibah, GA 30815 - Phone
- (706) 771-7001
- NPI assigned
- Sep 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN013334 | GA | Primary |
Addresses
Primary practice location
2636 Tobacco Rd
Suite a
Hephzibah, GA 30815
Mailing address
2511 Carriage Creek
Augusta, GA 30909
Phone (706) 733-1124
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN013334 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188345600000",
"number": "1154423390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2511 CARRIAGE CREEK",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "30909",
"telephone_number": "706-733-1124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2636 TOBACCO RD",
"address_2": "SUITE A",
"city": "HEPHZIBAH",
"state": "GA",
"postal_code": "30815",
"telephone_number": "706-771-7001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "ELEONORA",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-01",
"last_updated": "2007-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN013334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hephzibah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.