Jennifer Tummarello, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401415241 Issued in VA

Practice address

11208 Waples Mill Rd Ste 101
Fairfax, VA 22030-6077

Phone

(571) 723-2590

NPI assigned

May 17, 2016

Last updated

Oct 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 8, 2022 through Jun 8, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Tummarello and Pandak DDS, PC

  • General Practice Dentistry
  • Fairfax, VA
  • NPI 1437370384
  NPD (past)

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1740637099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11315 HUNT FARM LN",
            "city": "OAKTON",
            "state": "VA",
            "postal_code": "221241202",
            "telephone_number": "571-723-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11208 WAPLES MILL RD STE 101",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306077",
            "telephone_number": "571-723-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMMARELLO",
        "first_name": "JENNIFER",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401415241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ho Chung Tu, M.D.
• Tuan Nguyen, DDS, PC
• Jordan Michelle Tucker, PT DPT
• Stephanie Tucker, RCP
• Tummarello and Pandak DDS, PC
• Steven Brian Tunick, PHD
• Antoinette Tupper
• Elizabeth Claire Turcott, NP
• Judith Cornelius Turcott
• Kathleen Turek

• Dentist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.