Jenniffer Rendon-Velasquez, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02691100 Issued in NJ

Practice address

3817 Gruber Rd
Fort Bragg, NC 28310-8925

Phone

(910) 396-1571

NPI assigned

Jun 26, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1588159263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4027 SOUTHERN OAKS DR UNIT 2",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283140987",
            "telephone_number": "201-478-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3817 GRUBER RD",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283108925",
            "telephone_number": "910-396-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDON-VELASQUEZ",
        "first_name": "JENNIFFER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02691100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Rehm, DO
• Yvonne Reid
• Matthew Reinhardt, MD
• Kristen J Reiniche, PA-C
• Colleen Margaret Reminsky, LAT, ATC
• Shalonda Lichelle Renois, PHARM.D.
• Brandon Earl Resor, PA-C
• Shanna Reyes, PSY.D.
• Destiny R Reynolds, FNPC
• Tyler Chance Reynolds, LCSW

• General Practice Dentistry in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.