Active NPI
Todd Michael Jenny, D.D.S.
- Periodontics
- Worcester, MA
National Provider Identifier
1285075614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN1857286
- Practice address
- 405 Grove St
#300
Worcester, MA 01605-1270 - Phone
- (508) 753-5444
- NPI assigned
- Jul 15, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN1857286 | MA | Primary |
Addresses
Primary practice location
405 Grove St
#300
Worcester, MA 01605-1270
Mailing address
405 Grove St
#300
Worcester, MA 01605-1270
Phone (508) 753-5444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20160407001571 | FL | Order and Referring Only - Oral Surgery | 3274831219 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN1857286 | MA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470182400000",
"number": "1285075614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 GROVE ST",
"address_2": "#300",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016051270",
"telephone_number": "508-753-5444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 GROVE ST",
"address_2": "#300",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016051270",
"telephone_number": "508-753-5444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNY",
"first_name": "TODD",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-15",
"last_updated": "2016-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MA",
"license": "DN1857286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.