Active NPI
Jennifer Paress Caroline, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- DS039509
- Practice address
- 3400 Spruce St
Philadelphia, PA 19104-4206 - Phone
- (215) 662-3580
- NPI assigned
- Jun 11, 2013
- Last updated
- Jun 11, 2013
- 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DS039509 | PA | Primary |
Addresses
Primary practice location
3400 Spruce St
Philadelphia, PA 19104-4206
Mailing address
3400 Spruce St
Philadelphia, PA 19104-4206
Phone (215) 662-3580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS039509 | PA | MD | Oral and Maxillofacial Surgery (Dentist) |
| 124 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TMH Physician Associates PLLC | Current | Accepting new patients | |
| TMH Physician Associates PLLC | Current | Accepting new patients | |
| Makan Tarzana Dental Corporation | Oral and Maxillofacial Surgery | Current | Accepting new patients |
| Houston Methodist Oral and Maxillofacial Surgeons, PLLC | Past | Accepting new patients |
Locations
18372 Clark St
Ste 224
Tarzana, CA 91356
Phone (818) 996-1200
6550 Fannin St
#1280
Houston, TX 77030
Phone (713) 441-5577
6550 Fannin St
Ste 447
Houston, TX 77030
Phone (713) 441-0633
7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955
Interoperability endpoints
- jcaroline853319@direct.memorialcare.org
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Oral and Maxillofacial Surgery (Dentist)
- Tarzana, CA
- NPI 1700536810
-
- Ophthalmology Physician
- Houston, TX
- NPI 1275779225
-
- Orthopaedic Surgery Physician
- Spring, TX
- NPI 1043061351
-
- Oral & Maxillofacial Surgery (D.M.D.)
- Houston, TX
- NPI 1306646286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370908800000",
"number": "1447698519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044206",
"telephone_number": "215-662-3580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044206",
"telephone_number": "215-662-3580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAROLINE",
"first_name": "JENNIFER",
"middle_name": "PARESS",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-11",
"last_updated": "2013-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "PA",
"license": "DS039509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.