Individual provider Active NPI

Jena Baugh, DMD

  • General Practice Dentistry
  • Fort Payne, AL
National Provider Identifier
1568020402
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0006626-C1 Issued in AL
Practice address
302 4TH St SW
Fort Payne, AL 35967-1840
Phone
(256) 845-7300
NPI assigned
Jun 5, 2019
Last updated
Jun 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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 0006626-C1 AL Primary

Addresses

Primary practice location

302 4TH St SW
Fort Payne, AL 35967-1840

Mailing address

302 4TH St SW
Fort Payne, AL 35967-1840
Phone (256) 845-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20191112001853 AL Order and Referring Only - DentistPractitioner - Dentist 1254763303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0006626-C1ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony M Vizzinia Past Accepting new patients
Dr Anthony Vizzinia, DMD PC General Practice Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1568020402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 4TH ST SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359671840",
            "telephone_number": "256-845-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 4TH ST SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359671840",
            "telephone_number": "256-845-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUGH",
        "first_name": "JENA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "0006626-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

Verify at the official NPI Registry.