Individual provider Active NPI

Ritz Joy Jen, D.M.D.

  • Dentist
  • Roswell, GA
National Provider Identifier
1245613637
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN014975 Issued in GA
Practice address
800 Mansell Rd
Roswell, GA 30076-1797
Phone
(770) 642-9900
NPI assigned
Jul 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN014975 GA Primary

Addresses

Primary practice location

800 Mansell Rd
Roswell, GA 30076-1797

Mailing address

800 Mansell Rd
Roswell, GA 30076-1797
Phone (770) 642-9900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20170626001269 GA Order and Referring Only - DentistPractitioner - Dentist 6800164377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1245613637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MANSELL RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761797",
            "telephone_number": "770-642-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MANSELL RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761797",
            "telephone_number": "770-642-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEN",
        "first_name": "RITZ",
        "middle_name": "JOY",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.