Dale CR Jenkins, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DD2097 Issued in NM

Practice address

2145 Caja del Oro Grant Rd
Santa Fe, NM 87507-3279

Phone

(505) 474-1438

Fax

(505) 424-5699

NPI assigned

Dec 15, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

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

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841276573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 CAJA DEL ORO GRANT RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875073279",
            "telephone_number": "505-474-1438",
            "fax_number": "505-424-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 CAJA DEL ORO GRANT RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875073279",
            "telephone_number": "505-474-1438",
            "fax_number": "505-424-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "DALE",
        "middle_name": "CR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD2097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9179749",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DD2097",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey M Ross, MD, PC
• Theresa Jean Jeffries, LCSW
• Amy Jelliffe, MD
• Steven Arnold Jenison, M.D.
• Adrienne Jenkins, BSN, WHCNP
• Daniel Jenkins
• Francesca Jenkins
• Judith G. Jenkins, DDS
• William Chandler Jenkins Jr., LMHC
• Michele M Jenne, RN

• Dentist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Dentist in New Mexico

• 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.