Jeffrey Penner, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

ETN472 Issued in TX

Practice address

4205 Hillsboro Pike Ste 101
Nashville, TN 37215-3381

Phone

(615) 297-8973

NPI assigned

Jan 4, 2017

Last updated

Dec 10, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TN

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

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.

• Periodontal & Implant Associates of Middle Tennessee, PLLC

  • Periodontics
  • Nashville, TN
  • NPI 1174952642
  NPD

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1952846651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 HILLSBORO PIKE STE 101",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372153381",
            "telephone_number": "615-297-8973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 HILLSBORO PIKE STE 101",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372153381",
            "telephone_number": "615-297-8973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-04",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "ETN472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milton Earl Penn, DPM
• Roslyn Revella Penn, MS PSYCHOLOGY
• Stephanie Pennacchia, MS
• Sarah Catherine Pennebaker
• Christopher Lynn Pennell, PTA
• Adrienne Nicole Pennington, NP-C
• Brent E Pennington, M.D.
• Erica Lynn Pennington, NP
• Kathleen Emerson Pennington, APN, LMFT
• Laura Crystal Pennington, CRNA

• Periodontics in Nashville, TN
• Providers in Nashville, TN by specialty
• Periodontics in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.