Robert Leon Jeanmenne, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS035349 Issued in PA

Practice address

110 Radnor Rd Ste 200
State College, PA 16801-7987

Phone

(814) 238-2020

Fax

(814) 238-0005

NPI assigned

Dec 4, 2006

Last updated

Jan 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cosmetic Dentistry Inc

  • General Practice Dentistry
  • State College, PA
  • NPI 1043626450
  NPD Authorized official
• Nittany Dental, Inc.

  dba Nittany Dental Associates

  • General Practice Dentistry
  • State College, PA
  • NPI 1356462337
  NPD (past) Authorized official

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1730247933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 RADNOR RD STE 200",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017987",
            "telephone_number": "814-238-2020",
            "fax_number": "814-238-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 RADNOR RD STE 200",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017987",
            "telephone_number": "814-238-2020",
            "fax_number": "814-238-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANMENNE",
        "first_name": "ROBERT",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS035349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Irene Jaglowski, LSW
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• JC Blair Memorial Hospital (Penn Highlands State College, A Campus of Penn Highlands Huntingdon)
• JC Blair Memorial Hospital (Penn Highlands State College, A Campus of Penn Highlands Huntingdon)
• Jeffrey H Baker, MD, PC
• Kathy Jane Jeffries
• Jesse J. Jennings, MD
• Jessica Buckland
• Jessica C Effrig Psychotherapy LLC

• General Practice Dentistry in State College, PA
• Providers in State College, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.