Active NPI
Jenna Garvin, DDS
- General Practice Dentistry
- Barksdale AFB, LA
National Provider Identifier
1407484561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30.026193
- Practice address
- 1067 Twining Dr BLDG 4666
Barksdale AFB, LA 71110-2486 - Phone
- (318) 456-6718
- NPI assigned
- Apr 1, 2020
- 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 | 30.026193 | OH | Primary |
Addresses
Primary practice location
1067 Twining Dr BLDG 4666
Barksdale AFB, LA 71110-2486
Mailing address
1067 Twining Dr
Barksdale AFB, LA 71110-2486
Phone (318) 456-6718
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30.026193 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1407484561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1067 TWINING DR",
"city": "BARKSDALE AFB",
"state": "LA",
"postal_code": "711102486",
"telephone_number": "318-456-6718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1067 TWINING DR BLDG 4666",
"city": "BARKSDALE AFB",
"state": "LA",
"postal_code": "711102486",
"telephone_number": "318-456-6718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARVIN",
"first_name": "JENNA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-01",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30.026193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barksdale AFB, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.