Individual provider Active NPI

Jennifer Allen, D.M.D.

  • Dentist
  • Braintree, MA
National Provider Identifier
1679986855
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1856554 Issued in MA
Practice address
382 Grove St
Braintree, MA 02184-7324
Phone
(781) 843-1072
Fax
(781) 843-7880
NPI assigned
Jun 5, 2014
Last updated
Jun 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1856554 MA Primary

Addresses

Primary practice location

382 Grove St
Braintree, MA 02184-7324

Mailing address

382 Grove St
Braintree, MA 02184-7324
Phone (781) 843-1072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150616000757 MA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6305157470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1856554MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1679986855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 GROVE ST",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021847324",
            "telephone_number": "781-843-1072",
            "fax_number": "781-843-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 GROVE ST",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021847324",
            "telephone_number": "781-843-1072",
            "fax_number": "781-843-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braintree, MA

Sources for this page

Verify at the official NPI Registry.