Individual provider Active NPI

Jennifer Davis Enlow, D.D.S.

  • General Practice Dentistry
  • Ellicott City, MD
National Provider Identifier
1477858876
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13258 Issued in MD
Practice address
5126 Dorsey Hall Dr
Ellicott City, MD 21042-7887
Phone
(410) 740-9400
Fax
(410) 740-2105
NPI assigned
Jan 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13258 MD Primary

Addresses

Primary practice location

5126 Dorsey Hall Dr
Ellicott City, MD 21042-7887

Mailing address

7132 Elk Mar Dr
Elkridge, MD 21075-1097
Phone (410) 379-3092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20160211000831 MD Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3173827128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1477858876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7132 ELK MAR DR",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210751097",
            "telephone_number": "410-379-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5126 DORSEY HALL DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427887",
            "telephone_number": "410-740-9400",
            "fax_number": "410-740-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENLOW",
        "first_name": "JENNIFER",
        "middle_name": "DAVIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-14",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.