Individual provider Active NPI

Jenna Zacharewicz, DMD

  • Dentist
  • Wellington, FL
National Provider Identifier
1316516966
Registry record updated Jan 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
26055 Issued in FL
Practice address
1037 S State Road 7 Ste 211
Wellington, FL 33414-6139
Phone
(954) 415-1297
NPI assigned
Jun 18, 2021
Last updated
Jan 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 26055 FL Primary

Addresses

Primary practice location

1037 S State Road 7 Ste 211
Wellington, FL 33414-6139

Mailing address

5920 NW 63Rd PL
Parkland, FL 33067-4420
Phone (954) 415-1297

Other practice location 1

1720 N University Dr
Coral Springs, FL 33071-6090
Phone (954) 345-2264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26055FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adam Barbag, DMD PA PastSince Jan 1, 2023 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": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672617600000",
    "number": "1316516966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 NW 63RD PL",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330674420",
            "telephone_number": "954-415-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 S STATE ROAD 7 STE 211",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146139",
            "telephone_number": "954-415-1297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 N University Dr",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330716090",
            "country_code": "US",
            "telephone_number": "954-345-2264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZACHAREWICZ",
        "first_name": "JENNA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "26055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; 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.