Christy Mary Jen, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

118813 Issued in AK

Practice address

4200 Lake Otis Pkwy
Anchorage, AK 99508

Phone

(907) 562-1003

NPI assigned

Jun 14, 2011

Sex

Female

Sole proprietor

No

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 LA

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

Practice roles

Interoperability endpoints

• Direct secure messaging: cjen@direct.scf.cc

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.

• Alaska Native Tribal Health Consortium

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1437189339
  NPD

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1376838714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 LAKE OTIS PKWY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085226",
            "telephone_number": "907-562-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 LAKE OTIS PKWY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-562-1003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 N University Ave",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481091078",
            "country_code": "US",
            "telephone_number": "206-351-3320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEN",
        "first_name": "CHRISTY",
        "middle_name": "MARY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AK",
            "license": "118813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey D Medland, LLC
• Jeffrey S. Moore MD and Elisha T. Powell IV MD LLC
• Jeffrey W. Molloy, M.D, P.C.
• Tatjana Jelic, RPH
• Pamela Jemison
• Corinne Mehri Jenab
• Stacy Jencks, RN
• Jeng Sallah Alh
• Samba Jeng
• Sue Anne Jenkerson, RNC, FNP

• Pediatric Dentistry in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Pediatric Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.