Jeffrey Neil Pennington, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16202 Issued in FL

Practice address

1541 The Greens Way
Jacksonville Beach, FL 32250-2449

Phone

(904) 280-3347

Fax

(904) 285-0207

NPI assigned

Dec 19, 2006

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

Enrolled in GA, FL2 enrollments

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 2

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.

• Parker and Pennington Dentistry

  • General Practice Dentistry
  • Jacksonville Beach, FL
  • NPI 1215131875
  NPD (past) Authorized official

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780747790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 THE GREENS WAY",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502449",
            "telephone_number": "904-280-3347",
            "fax_number": "904-285-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 THE GREENS WAY",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502449",
            "telephone_number": "904-280-3347",
            "fax_number": "904-285-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "JEFFREY",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "16202",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "012685",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Associates of Northeast Florida, LLC (Jacksonville Pediatric Associates)
• Barbara Peeples, APRN
• Heather E Peltack, BCBA
• Erin D Pemberton, OTD
• Rebecca Jean Penna, PH.D.
• Lydia Keller Pennington
• Aaron Percoco, RMHCI
• Performance Physical Medicine and Rehab (Performance Physical Medicine)
• Laura R Peter, D.O.
• Madison Harris Petersen, NP

• General Practice Dentistry in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.