Individual provider Active NPI

Jeremy R Jannuzzi, D.M.D, M.D.

  • Dentist
  • Englewood, CO
National Provider Identifier
1679784987
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10731 Issued in CO
Practice address
125 Inverness Dr E
Suite 100
Englewood, CO 80112-5137
Phone
(303) 773-8228
Fax
(303) 773-0142
NPI assigned
May 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10731 CO Primary

Addresses

Primary practice location

125 Inverness Dr E
Suite 100
Englewood, CO 80112-5137

Mailing address

125 Inverness Dr E
Suite 100
Englewood, CO 80112-5137
Phone (303) 773-8228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20121227000164 CO Practitioner - Oral Surgery 7517110562 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Case Western University School of Dental Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trauma and Emergency Subspecialty Surgeons PLLCGroup PAC ID 1951559293, 27 clinicians

Practice addresses (Care Compare)

10101 Ridgegate Pkwy
Lone Tree, CO 80124-5522
Phone (720) 225-1000

7700 S Broadway
Littleton, CO 80122-2602
Phone (303) 730-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10731COMDDentist

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.

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1679784987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 INVERNESS DR E",
            "address_2": "SUITE 100",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801125137",
            "telephone_number": "303-773-8228",
            "fax_number": "303-773-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 INVERNESS DR E",
            "address_2": "SUITE 100",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801125137",
            "telephone_number": "303-773-8228",
            "fax_number": "303-773-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANNUZZI",
        "first_name": "JEREMY",
        "middle_name": "R",
        "credential": "D.M.D, M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "10731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.