James Mallory Jenkins Jr., D.M.D.

Individual provider Active NPI Pediatric Dentistry · Montgomery, AL

NPI 1265837199 · NPPES record last updated Nov 4, 2014

Key facts

NPI
1265837199
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
2767 (AL)
Practice address
7015 Halcyon Park Dr
Montgomery, AL 36117-7763
Phone
(334) 284-1100
Fax
(334) 281-1245
NPI assigned
Nov 4, 2014
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2767ALMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists 4 Children, L.L.C. Pediatric Dentistry Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 2767 AL Yes

Addresses

Primary practice location

7015 Halcyon Park Dr
Montgomery, AL 36117-7763

Mailing address

7015 Halcyon Park Dr
Montgomery, AL 36117-7763
Phone (334) 284-1100

Other providers in Montgomery, AL

All providers in Montgomery, AL · Pediatric Dentistry in Alabama

Sources for this page

Verify at the official NPI Registry.