Jersey Ridge Dental Associates

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JERSEY RIDGE DENTAL ASSOCIATES

Practice address

5105 Jersey Ridge Road
Davenport, IA 52807-3134

Phone

(563) 359-9144

Fax

(563) 359-9146

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David L Samuelson

Title

Partner

Phone

(563) 359-9144

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Howard Douglas Robertson, DDS

  • General Practice Dentistry
  • Davenport, IA
  • NPI 1083791479
  NPD (past)
• Dustin Michael Smolenski, D.D.S

  • General Practice Dentistry
  • Davenport, IA
  • NPI 1245469881
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1194892521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 JERSEY RIDGE ROAD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073134",
            "telephone_number": "563-359-9144",
            "fax_number": "563-359-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 JERSEY RIDGE ROAD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073134",
            "telephone_number": "563-359-9144",
            "fax_number": "563-359-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY RIDGE DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "SAMUELSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "563-359-9144",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Lynn Jennings, DNP, ARNP
• Valerie Jennings, DDS
• Jennie Sue Jensen, RN
• Kathy Jensen, LISW
• Jersey Ridge Chiro & Rehab
• Jersey Ridge Place, L.L.C.
• Jestel Health Services, Inc.
• Jillyn Kaufman, PLC
• JMJ3 Heritage, L.L.C.
• Jmwellness PLLC

• General Practice Dentistry in Davenport, IA
• Providers in Davenport, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.