Jenelle Louise Fleagle, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30-023733 Issued in OH

Practice address

5509 Bendt Dr Ste 302
Rapid City, SD 57702-9460

Phone

(605) 939-7992

NPI assigned

Jul 10, 2012

Last updated

Aug 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dakota Dental 4 Kids

  • Community Health Worker
  • Rapid City, SD
  • NPI 1831076025
  NPD

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1851656375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5509 BENDT DR STE 302",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577029460",
            "telephone_number": "605-939-7992",
            "fax_number": "605-534-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5509 BENDT DR STE 302",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577029460",
            "telephone_number": "605-939-7992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEAGLE",
        "first_name": "JENELLE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-023733",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SD",
            "license": "D1324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0098381",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Fisher
• Anne Fisher, MD
• Nanette Fitzgerald
• Loretta M Flaitz, O.D., M.B.A.
• Maddison Flanagan, RBT
• Jenna Fleischacker, PT, DPT
• Jessica Flett
• Flexibil OT Inc
• Sarah Flick
• Dale Flint

• Dentist in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Dentist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.