NPIMap

Organization Active NPI

KKTZ

Doing business as Jennings & Larson Family Dentistry- Fort Mohave

  • General Practice Dentistry
  • Fort Mohave, AZ
National Provider Identifier
1861908857
Registry record updated Dec 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
KKTZ
Doing business as
Jennings & Larson Family Dentistry- Fort Mohave
Practice address
5221 Hwy 95 Ste 4
Fort Mohave, AZ 86426-9244
Phone
(928) 577-2533
NPI assigned
Dec 28, 2017
Last updated
Dec 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2017

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

Authorized official

Name
Dr. Thadd Jennings, DDS
Title
Member
Phone
(928) 201-5588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

5221 Hwy 95 Ste 4
Fort Mohave, AZ 86426-9244

Mailing address

5221 Hwy 95 Ste 4
Fort Mohave, AZ 86426-9244
Phone (928) 577-2533

Other names 1

  • Jennings & Larson Family Dentistry- Fort Mohave Doing business as

National Provider Directory

National Provider Directory
Tax ID family
KKTZ3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5221 S Highway 95
Ste 4
Fort Mohave, AZ 86426
Phone (928) 577-2533

NPI Registry JSON

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514419200000",
    "number": "1861908857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 HWY 95 STE 4",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864269244",
            "telephone_number": "928-577-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5221 HWY 95 STE 4",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864269244",
            "telephone_number": "928-577-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KKTZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-28",
        "last_updated": "2017-12-28",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "THADD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "928-201-5588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jennings & Larson Family Dentistry- Fort Mohave",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Mohave, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; 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.