Jennifer Gavrillen Walsh, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21320 Issued in MA

Practice address

200 N Main St
Suite 1104
East Longmeadow, MA 01028-2392

Phone

(413) 525-6123

Fax

(413) 525-8999

NPI assigned

Mar 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Jennifer Jameson Gavrillen Former name

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1141603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184691495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N MAIN ST",
            "address_2": "SUITE 1104",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010282392",
            "telephone_number": "413-525-6123",
            "fax_number": "413-525-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MAIN ST",
            "address_2": "SUITE 1104",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010282392",
            "telephone_number": "413-525-6123",
            "fax_number": "413-525-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "JENNIFER",
        "middle_name": "GAVRILLEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GAVRILLEN",
            "middle_name": "JAMESON",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vincent a Trimboli Jr DDS PC
• Walgreen Co
• Jeremy Walker
• Jennifer Wallace-Johnson
• Kelly M Wallace
• Avery Grace Warner, PA-C
• Shelly Warren, LICSW
• June Watts, LPC
• Lynne M Weidl, PT
• Welcoming Safe Space Therapeutic Services, Inc.

• General Practice Dentistry in East Longmeadow, MA
• Providers in East Longmeadow, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.

Verify at the official NPI Registry.