Maurice Gustaf Jenkins, D.D.S., M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6700 Issued in NE

Practice address

280 River Park Dr Ste 360
Provo, UT 84604-5835

Phone

(801) 437-7701

Fax

(801) 356-6326

NPI assigned

Jun 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2021 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Maurice G Jenkins PLLC

  dba Riverwood Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Provo, UT
  • NPI 1114781689
  NPD Authorized official

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1285831990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 RIVER PARK DR STE 360",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846045835",
            "telephone_number": "801-437-7701",
            "fax_number": "801-356-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 RIVER PARK DR STE 360",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846045835",
            "telephone_number": "801-437-7701",
            "fax_number": "801-356-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MAURICE",
        "middle_name": "GUSTAF",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NE",
            "license": "6700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey L Trapnell DDS PLLC (Trapnell Orthodontics)
• Shannon Jeffs
• Brandi Nicole Jenkins
• Joshua Dean Jenkins, L.C.S.W
• Leini Jenkins
• Paul H Jenkins, PHD
• Bryant Devaughn Jenks, MFT
• Evan Tyler Francis Jenny, HSW
• Megan E Jensen-Hill, PA-C
• Alia Mae Jensen, RBT

• Oral and Maxillofacial Surgery (Dentist) in Provo, UT
• Providers in Provo, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.