Active NPI
Amanda Lynn Jenney, DDS
- General Practice Dentistry
- Valencia, CA
National Provider Identifier
1346598455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 46835
- Practice address
- 25880 Tournament Rd
Suite 212
Valencia, CA 91355-2349 - Phone
- (661) 254-5588
- NPI assigned
- Aug 21, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 46835 | CA | Primary |
Addresses
Primary practice location
25880 Tournament Rd
Suite 212
Valencia, CA 91355-2349
Mailing address
25880 Tournament Rd
Suite 212
Valencia, CA 91355-2349
Phone (661) 254-5588
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150915001042 | CA | Order and Referring Only - Dentist | 4082921689 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46835 | CA | MD | Non-emergency Medical Transport (VAN) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avaness Dental Group Inc | Past | 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 and National Provider Directory roles.
-
- Dentist
- Santa Clarita, CA
- NPI 1790439024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345507200000",
"number": "1346598455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25880 TOURNAMENT RD",
"address_2": "SUITE 212",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913552349",
"telephone_number": "661-254-5588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25880 TOURNAMENT RD",
"address_2": "SUITE 212",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913552349",
"telephone_number": "661-254-5588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNEY",
"first_name": "AMANDA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-21",
"last_updated": "2012-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "46835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valencia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; 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.