Maritza O Jenkins, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009822 Issued in IN

Practice address

3823 E Morgan Ave
Evansville, IN 47715-2241

Phone

(812) 474-1020

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1306934229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3823 E MORGAN AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152241",
            "telephone_number": "812-474-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3823 E MORGAN AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152241",
            "telephone_number": "812-474-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MARITZA",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200089640A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghann Jeffries, MSW, LCSW
• James E Jenison, MD
• Jennifer Odean Jenkins, PT
• Joseph R Jenkins, M.D.
• Kari Jenkins, COTA
• Crystal Amber Jennings, CFSA
• Jennmike Inc.
• Jenny McWilliams DDS PC
• Sheila Ann Jensen, NP
• Barbara Carol Jessen, PSY.D.

• 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 Feb 9, 2015; 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.

Verify at the official NPI Registry.