Individual provider Active NPI

Jenna Fewins

  • Oral and Maxillofacial Radiology Dentistry
  • Bethesda, MD
National Provider Identifier
1558777037
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X
License
2901021801 Issued in MI
Practice address
4494 Palmer Rd N
Bethesda, MD 20814
Phone
(301) 295-4000
NPI assigned
Jul 7, 2014
Reactivated
Jun 20, 2018
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Radiology Dentistry 1223X0008X 2901021801 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

4494 Palmer Rd N
Bethesda, MD 20814

Mailing address

4494 Palmer Rd N
Bethesda, MD 20814

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL PACS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210707001720 MI Order and Referring Only - DentistPractitioner - Dentist 5991107443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901021801MIMDOral and Maxillofacial Radiology Dentist

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1558777037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4494 PALMER RD N",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4494 PALMER RD N",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20814",
            "telephone_number": "301-295-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEWINS",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "deactivation_date": "2018-05-29",
        "reactivation_date": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "MI",
            "license": "2901021801",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PACS",
            "affiliation": "N",
            "address_1": "620 John Paul Jones Cir",
            "city": "Portsmouth",
            "state": "VA",
            "country_code": "US",
            "postal_code": "237082111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.