Individual provider Active NPI

Jason Scott Ehrenman, D.M.D.

  • Periodontics
  • North Palm Beach, FL
National Provider Identifier
1730433749
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN19326 Issued in FL
Practice address
1216 US Highway 1 Ste B
North Palm Beach, FL 33408-3537
Phone
(561) 624-5307
NPI assigned
Oct 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DN19326 FL Primary

Addresses

Primary practice location

1216 US Highway 1 Ste B
North Palm Beach, FL 33408-3537

Mailing address

1216 US Highway 1 Ste B
North Palm Beach, FL 33408-3537
Phone (561) 624-5307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160225000508 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 1052616281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jason Ehrenman DMD MSD LLC Periodontics CurrentSince Feb 12, 2023 Accepting new patients
Palm Beach Periodontics, P.C. Periodontics Past Accepting new patients

Locations

1216 US Highway 1
Ste B
North Palm Beach, FL 33408
Phone (561) 624-5307

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": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1730433749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 US HIGHWAY 1 STE B",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334083537",
            "telephone_number": "561-624-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 US HIGHWAY 1 STE B",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334083537",
            "telephone_number": "561-624-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRENMAN",
        "first_name": "JASON",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-30",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN19326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.