Jeryl A Abbott-Kohn, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401008212 Issued in VA

Practice address

456 Charles H Dimmock Pkwy Ste 5
Colonial Heights, VA 23834-2936

Phone

(804) 520-4088

NPI assigned

Oct 2, 2007

Sex

Female

Sole proprietor

No

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.

• Jeryl a Abbott DDS PC

  • General Practice Dentistry
  • Midlothian, VA
  • NPI 1518418144
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 20, 2017 through Apr 20, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 2, 2007.

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1679760813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 CHARLES H DIMMOCK PKWY STE 5",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342936",
            "telephone_number": "804-520-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 CHARLES H DIMMOCK PKWY STE 5",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342936",
            "telephone_number": "804-520-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOTT-KOHN",
        "first_name": "JERYL",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401008212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A & J Home Health LLC
• A Wright Pond DDS LTD
• Lonia Faith Abbott, M.D.
• Hamza Husam Abdul-Samad
• Nevine Aboualim
• Abundant Life Center Intensive in-Home Services
• Richard Acevedo, PHYSICIAN ASSISTANT

• All providers in Colonial Heights, VA
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.