Active NPI
Terrance Dale Jennings, DDS
- Dentist
- Fort Smith, AR
National Provider Identifier
1780769844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1955
- Practice address
- 2910 Jenny Lind Road
Suite 7
Fort Smith, AR 72901-6733 - Phone
- (479) 785-4107
- Fax
- (479) 494-7638
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1955 | AR | Primary |
Addresses
Primary practice location
2910 Jenny Lind Road
Suite 7
Fort Smith, AR 72901-6733
Mailing address
2910 Jenny Lind Road
Suite 7
Fort Smith, AR 72901-6733
Phone (479) 785-4107
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58316 | Other | BLUE CROSS FEDERAL | |
| 835361 | Other | AR | BLUE CROSS STATE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1955 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780769844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2910 JENNY LIND ROAD",
"address_2": "SUITE 7",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729016733",
"telephone_number": "479-785-4107",
"fax_number": "479-494-7638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2910 JENNY LIND ROAD",
"address_2": "SUITE 7",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729016733",
"telephone_number": "479-785-4107",
"fax_number": "479-494-7638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "TERRANCE",
"middle_name": "DALE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "1955",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS FEDERAL",
"identifier": "58316",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS STATE",
"identifier": "835361",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.