Jennifer Rose Korzeb, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21360 Issued in MA

Practice address

436 Broadway
Village Mall Plaza
Methuen, MA 01844-2061

Phone

(978) 682-1002

Fax

(978) 682-1246

NPI assigned

Dec 28, 2005

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

Medicare fee-for-service enrollment

Enrolled in MA

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1376520759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 BROADWAY",
            "address_2": "VILLAGE MALL PLAZA",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018442061",
            "telephone_number": "978-682-1002",
            "fax_number": "978-682-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 BROADWAY",
            "address_2": "VILLAGE MALL PLAZA",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018442061",
            "telephone_number": "978-682-1002",
            "fax_number": "978-682-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORZEB",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc David Klein, DPM
• Ekaterina A Klevtsova, MD
• Kelsey R Kneeland, DPT
• Madison Knibbs, MOT, OTR/L
• Judith Rita Kong, RN
• Amy Marie Kostak
• Bhoomi Kotak, DMD
• Bianca Krapian, RN
• Danielle Marie Kreig, PHARMD, RPH
• Juliet M Kyotowadde, APRN-BC

• General Practice Dentistry in Methuen, MA
• Providers in Methuen, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.