Alyssa Jenkins
Individual provider Active NPI Dentist · Athens, OH
NPI 1922455740 · NPPES record last updated May 23, 2016
Key facts
- NPI
- 1922455740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 30.24767 (OH)
- Practice address
- 80 Columbus Rd
Athens, OH 45701-1312 - Phone
- (740) 594-6000
- NPI assigned
- May 23, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.24767 | OH | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jenkins Family Dental | Current | Accepting new patients | |
| Jenkins Family Dental | Current | Accepting new patients | |
| Jenkins Airway LLC | Current | Accepting new patients | |
| Athens Dental Depot, Michael D. Ginder DDS & Company | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.24767 | OH | Yes |
Addresses
Primary practice location
80 Columbus Rd
Athens, OH 45701-1312
Mailing address
80 Columbus Rd
Athens, OH 45701-1312
Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.