Individual provider Active NPI

Robert H.E. Jennings, D.D.S.

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1508051590
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42921 Issued in CA
Practice address
6501 Crown Blvd
Suite 206
San Jose, CA 95120-2903
Phone
(408) 268-3313
Fax
(408) 268-3314
NPI assigned
Sep 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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 42921 CA Primary

Addresses

Primary practice location

6501 Crown Blvd
Suite 206
San Jose, CA 95120-2903

Mailing address

6501 Crown Blvd
Suite 206
San Jose, CA 95120-2903
Phone (408) 268-3313

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

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1508051590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 CROWN BLVD",
            "address_2": "SUITE 206",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951202903",
            "telephone_number": "408-268-3313",
            "fax_number": "408-268-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 CROWN BLVD",
            "address_2": "SUITE 206",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951202903",
            "telephone_number": "408-268-3313",
            "fax_number": "408-268-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "ROBERT",
        "middle_name": "H.E.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.