Jennifer Stodder, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

107004 Issued in CA

Practice address

3405 Kenyon St Ste 510
San Diego, CA 92110-5008

Phone

(619) 223-7189

NPI assigned

Nov 3, 2019

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

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.

• Michael G. McMahon Professional Dental Corporation

  • Corporate Health Clinic/Center
  • San Diego, CA
  • NPI 1538686126
  NPD

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

{
    "created_epoch": "1572739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1619511680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7905 CALLE OLIVA",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920092909",
            "telephone_number": "760-994-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 KENYON ST STE 510",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105008",
            "telephone_number": "619-223-7189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDER",
        "first_name": "JENNIFER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-03",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xochitl Artemiza Stockton, REGISTERED NURSE
• Jennifer Stockwell, AUD
• Rachel Stockwell
• Jill A Stoddard, PH.D.
• Stephanie Ann Stoddart, LCSW
• Stacey Spencer Stoefen
• Rebecca Ann Stoffel, LCSW
• Nataliya Stogniy
• Grace J Stojanov, L.AC., DIPL. O.M.
• Michael Boyd Stoker, AMFT

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.