Joshua Steven Jenkins, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN014652 Issued in GA

Practice address

210 Fairview Rd
Ellenwood, GA 30294-2704

Phone

(770) 474-3418

NPI assigned

Aug 13, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shawn a. Walls, DDS, PC

  • General Practice Dentistry
  • Johns Creek, GA
  • NPI 1093411910
  NPD (past)
• Shawn a. Walls, DDS, PC

  • General Practice Dentistry
  • Johns Creek, GA
  • NPI 1376929125
  NPD (past)

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1699108753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 FAIRVIEW RD",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942704",
            "telephone_number": "770-474-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 FAIRVIEW RD",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942704",
            "telephone_number": "770-474-3418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10700 Medlock Bridge Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Johns Creek",
            "state": "GA",
            "postal_code": "300978455",
            "country_code": "US",
            "telephone_number": "770-813-0079",
            "fax_number": "334-756-6651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "JOSHUA",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-13",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "6055",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David James, ATC
• Imani Jean-Pierre
• JL Patterson Enterprises, Inc
• Khyale Lamona Johnson
• Deborah Jones, PT
• Jazmyn Jones
• Marcus Lance Jones, LPC, CADCII

• General Practice Dentistry in Ellenwood, GA
• Providers in Ellenwood, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.