Individual provider Active NPI

Jenna A Prano, D.D.S.

  • Dentist
  • Battle Creek, MI
National Provider Identifier
1639439383
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020631 Issued in MI
Practice address
101 N 20TH St
Battle Creek, MI 49015-1701
Phone
(269) 963-1746
NPI assigned
May 29, 2012
Last updated
Apr 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020631 MI Primary

Addresses

Primary practice location

101 N 20TH St
Battle Creek, MI 49015-1701

Mailing address

101 N 20TH St
Battle Creek, MI 49015-1701

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
I20160224002060 MI Order and Referring Only - DentistPractitioner - Dentist 8325343619

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020631MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kristen Gable, DMD PLC CurrentSince Apr 30, 2023 Accepting new patients

Locations

101 N 20th St
Battle Creek, MI 49015
Phone (269) 963-1746

Organizations & group practices 1

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": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1639439383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N 20TH ST",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490151701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N 20TH ST",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490151701",
            "telephone_number": "269-963-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRANO",
        "first_name": "JENNA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-29",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.