Jerin NMN Joseph, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN24821 Issued in FL

Practice address

6958 Nebraska Ave
BLDG 1608
Fort Leonard Wood, MO 65473-1618

Phone

(573) 596-0411

Fax

(573) 596-0410

NPI assigned

Aug 12, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1548714090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6958 NEBRASKA AVE",
            "address_2": "BLDG 1608",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654731618",
            "telephone_number": "573-596-0411",
            "fax_number": "573-596-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6958 NEBRASKA AVE",
            "address_2": "BLDG 1608",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654731618",
            "telephone_number": "573-596-0411",
            "fax_number": "573-596-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "JERIN",
        "middle_name": "NMN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-12",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "041013",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David R Johnson, LCSW
• Susan K Johnson, MS PHARMACY
• Melissa Rose Jones, RN, BSN, SANE
• Phyllis Joan Jones, RN-C
• Trina Marie Jones, R.N.
• Sarah Elizabeth Joy, PA
• Callie Juhas
• Angela Kays
• Sarah Keelin, RN
• Bradley Kelley, DMD

• Dentist in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.