Individual provider Active NPI

Jennifer Lindsay Marks, DDS

  • General Practice Dentistry
  • Tampa, FL
National Provider Identifier
1316479959
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24516 Issued in FL
Practice address
4302 Henderson Blvd Ste 117
Tampa, FL 33629-5693
Phone
(813) 839-2273
NPI assigned
Apr 2, 2017
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 24516 FL Primary

Addresses

Primary practice location

4302 Henderson Blvd Ste 117
Tampa, FL 33629-5693

Mailing address

4302 Henderson Blvd Ste 117
Tampa, FL 33629-5693
Phone (607) 235-4430

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191219001656 FL Order and Referring Only - DentistPractitioner - Dentist 5890129118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24516FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Deep Roots Project, LLC General Practice PastSince Mar 3, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1491091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1316479959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 HENDERSON BLVD STE 117",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295693",
            "telephone_number": "607-235-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 HENDERSON BLVD STE 117",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295693",
            "telephone_number": "813-839-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "JENNIFER",
        "middle_name": "LINDSAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-02",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "24516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.