Active NPI
Joshua Alan Jenkins, D.M.D.
- Pediatric Dentistry
- Twin Falls, ID
National Provider Identifier
1659682912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- D-4569-PD
- Practice address
- 1411 Falls Ave E
#1000C
Twin Falls, ID 83301-3455 - Phone
- (208) 734-7415
- Fax
- (208) 734-7415
- NPI assigned
- Jul 1, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | D-4569-PD | ID | Primary |
Addresses
Primary practice location
1411 Falls Ave E
#1000C
Twin Falls, ID 83301-3455
Mailing address
1411 Falls Ave E
#1000C
Twin Falls, ID 83301-3455
Phone (208) 734-7415
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 |
|---|---|---|---|
| D-4569-PD | ID | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485388800000",
"number": "1659682912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 FALLS AVE E",
"address_2": "#1000C",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833013455",
"telephone_number": "208-734-7415",
"fax_number": "208-733-1922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 FALLS AVE E",
"address_2": "#1000C",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833013455",
"telephone_number": "208-734-7415",
"fax_number": "208-734-7415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "JOSHUA",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-01",
"last_updated": "2017-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "ID",
"license": "D-4569-PD",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.