Active NPI
Timothy David Jennings, DDS
- General Practice Dentistry
- Nashville, TN
National Provider Identifier
1649565342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 27673
- Practice address
- 618 Church St
Suite 520
Nashville, TN 37219-2428 - Phone
- (615) 750-0342
- Fax
- (615) 986-1705
- NPI assigned
- Jun 10, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DEN-10459 | CO | |
| General Practice Dentistry | 1223G0001X | 27673 | TX | Primary |
Addresses
Primary practice location
618 Church St
Suite 520
Nashville, TN 37219-2428
Mailing address
2859 E Fountain Blvd
Colorado Springs, CO 80910-2312
Phone (719) 442-0071
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN-10459 | CO | MD | Dentist |
| 27673 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Dental Clinic of Charleston, LLC | Past | Accepting new patients | |
| Albany Access Dentistry, PLLC | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Nashville, TN
- NPI 1548498587
-
- Nurse Practitioner
- North Charleston, SC
- NPI 1730467978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625097600000",
"number": "1649565342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2859 E FOUNTAIN BLVD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809102312",
"telephone_number": "719-442-0071",
"fax_number": "719-473-5303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 CHURCH ST",
"address_2": "SUITE 520",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372192428",
"telephone_number": "615-750-0342",
"fax_number": "615-986-1705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "TIMOTHY",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-10",
"last_updated": "2021-07-01",
"certification_date": "2021-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "DEN-10459",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "27673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.