Active NPI
Jennifer Lynn Watkins, D.D.S
- Dentist
- Oakdale, MN
National Provider Identifier
1275864258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D12722
- Practice address
- 1099 Helmo Ave N Ste 200
Oakdale, MN 55128-6037 - Phone
- (651) 770-9174
- NPI assigned
- Jan 15, 2010
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D12722 | MN | Primary |
Addresses
Primary practice location
1099 Helmo Ave N Ste 200
Oakdale, MN 55128-6037
Mailing address
390 Herschel St
Saint Paul, MN 55104-3602
Phone (651) 343-5315
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160310002625 | MN | Order and Referring Only - Dentist | 5496051807 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D12722 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368489600000",
"number": "1275864258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 HERSCHEL ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551043602",
"telephone_number": "651-343-5315",
"fax_number": "651-343-5315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1099 HELMO AVE N STE 200",
"city": "OAKDALE",
"state": "MN",
"postal_code": "551286037",
"telephone_number": "651-770-9174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATKINS",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-15",
"last_updated": "2013-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D12722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakdale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.