Jennifer M Ortiz, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

055827 Issued in NY

Practice address

107 W 4TH St
Mount Vernon, NY 10550-4002

Phone

(914) 699-7200

Fax

(914) 699-0837

NPI assigned

Sep 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Connecticut Dental Professionals, P.C.

  • General Practice Dentistry
  • Oxford, CT
  • NPI 1083256226
  NPD (past)

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1538442017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "055827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02995513",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03406879",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ifeyinwa Onyeaka
• Obianulo Rose Onyema, MD
• Zipporah Oparebea Opare, HEALTH WELLNES COACH
• Jacqueline Ortega, BSN, RN
• Amaris Ortiz
• Nonso Osakwe, M.D.
• Henrietta Osei
• Alannah Overton
• Alexandra Aboagye Owusu
• Dorothy Asantewaa Owusu, RN

• General Practice Dentistry in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.

Verify at the official NPI Registry.