Individual provider Active NPI

Jennifer R Milazzo, DMD

  • General Practice Dentistry
  • Mobile, AL
National Provider Identifier
1508929688
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5150 Issued in AL
Practice address
120 S University Boulevard
Suite C1
Mobile, AL 36608-3045
Phone
(251) 342-2324
Fax
(251) 342-2405
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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 5150 AL Primary

Addresses

Primary practice location

120 S University Boulevard
Suite C1
Mobile, AL 36608-3045

Mailing address

120 S University Boulevard
Suite C1
Mobile, AL 36608-3045
Phone (251) 342-2324

Other names 1

  • Dr. Jennifer R Glass Former name

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1508929688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S UNIVERSITY BOULEVARD",
            "address_2": "SUITE C1",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083045",
            "telephone_number": "251-342-2324",
            "fax_number": "251-342-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S UNIVERSITY BOULEVARD",
            "address_2": "SUITE C1",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083045",
            "telephone_number": "251-342-2324",
            "fax_number": "251-342-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILAZZO",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GLASS",
            "middle_name": "R",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.