Jessica Hancock Renaker, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12011438A Issued in IN

Practice address

508 N Green River Rd
Evansville, IN 47715-2412

Phone

(812) 479-5000

NPI assigned

Jul 1, 2010

Last updated

Mar 19, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dustin R Harper DMD LLC

  • Dentist
  • Evansville, IN
  • NPI 1932495629
  NPD (past)

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1285945550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 N GREEN RIVER RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152412",
            "telephone_number": "812-479-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 N GREEN RIVER RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152412",
            "telephone_number": "812-479-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENAKER",
        "first_name": "JESSICA",
        "middle_name": "HANCOCK",
        "name_prefix": "Ms.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011438A",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8890",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Britt Reisman
• Jonathan William Reitz, DDS
• Reliable Care Adult Day Care Inc.
• Reliant Family Dental
• Olivia A Reller, RN
• Renal Life Link Inc (East Evansville Dialysis)
• Renal Life Link Inc (North Evansville Dialysis)
• Renal Treatment Centers Mid Atlantic Inc (East Evansville Dialysis)
• James W Renne, MD
• Todd D Renschler, MD

• General Practice Dentistry in Evansville, IN
• Providers in Evansville, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.