Active NPI
Jeannette Marie Jimenez-Rodriguez, DMD
- Endodontics
- Marietta, GA
National Provider Identifier
1205809845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 050038
- Practice address
- 1343 Siesta LN
Marietta, GA 30062-2815 - Phone
- (646) 771-6675
- NPI assigned
- Feb 13, 2006
- Last updated
- Jan 7, 2021
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 050038 | NY | Primary |
Addresses
Primary practice location
1343 Siesta LN
Marietta, GA 30062-2815
Mailing address
4707 Cheviot Way SE
Smyrna, GA 30080-9257
Phone (646) 771-2275
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 |
|---|---|---|---|
| 050038 | NY | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bluetooth Endo LLC | Endodontics | Current | Accepting new patients |
| JMJ Endodontics | Endodontics | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Georgia Microendodontics of Alpharetta
- Endodontics
- Alpharetta, GA
- NPI 1760319602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609977600000",
"number": "1205809845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4707 CHEVIOT WAY SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300809257",
"telephone_number": "646-771-2275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1343 SIESTA LN",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300622815",
"telephone_number": "646-771-6675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ-RODRIGUEZ",
"first_name": "JEANNETTE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-13",
"last_updated": "2021-01-07",
"certification_date": "2021-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NY",
"license": "050038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.