Active NPI
James Ray Jenkins II
- Pediatric Dentistry
- Gambrills, MD
National Provider Identifier
1437561487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 16592
- Practice address
- 2410 Evergreen Rd Ste 101
Gambrills, MD 21054 - Phone
- (225) 810-7962
- NPI assigned
- May 27, 2014
- Reactivated
- Dec 5, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 16592 | MD | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 008416067 | LA | |
| Pediatric Dentistry | 1223P0221X | 16592 | MD | Primary |
Addresses
Primary practice location
2410 Evergreen Rd Ste 101
Gambrills, MD 21054
Mailing address
2410 Evergreen Rd Ste 101
Gambrills, MD 21054
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 |
|---|---|---|---|
| 16592 | MD | MD | General Practice Dentistry |
| 008416067 | LA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549411200000",
"number": "1437561487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2410 EVERGREEN RD STE 101",
"city": "GAMBRILLS",
"state": "MD",
"postal_code": "21054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 EVERGREEN RD STE 101",
"city": "GAMBRILLS",
"state": "MD",
"postal_code": "21054",
"telephone_number": "225-810-7962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "JAMES",
"middle_name": "RAY",
"name_prefix": "Dr.",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-27",
"last_updated": "2019-02-06",
"deactivation_date": "2018-11-15",
"reactivation_date": "2018-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "16592",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "LA",
"license": "008416067",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MD",
"license": "16592",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gambrills, MD
- Rachel Inman Segura, NP
- Integrated Medicine and Wellness Center, LLC
- Farid Israel, RPH
- Karen Renee' Jackson-Williams, DOM, LAC
- James Perritt Psychiatric NP LLC
- Jerome S. Casper Childrens Dental Office, P.a.
- John V. Demaio DC PC
- Karen Sue Jordan, OTR/L, C/LT, C/NDT
- Lisa Jurkiewicz
- Grace Kalakay, L.AC.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.