Jennifer Psota Dougherty, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

21039 Issued in OH

Practice address

7123 Pearl Rd
Suite 100
Cleveland, OH 44130-4975

Phone

(440) 888-6783

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Jennifer Psota Dougherty Other name

Medicare fee-for-service enrollment

Enrolled in OH

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jennifer Psota Dougherty DDS LLC

  • Dentist
  • Westlake, OH
  • NPI 1407159320
  NPD (past) Authorized official

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1962423541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 COLUMBIA RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441454102",
            "telephone_number": "440-835-0011",
            "fax_number": "440-250-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7123 PEARL RD",
            "address_2": "SUITE 100",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441304975",
            "telephone_number": "440-888-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PSOTA DOUGHERTY",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "21039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DOUGHERTY",
            "middle_name": "PSOTA",
            "prefix": "MRS.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Psalms of Love Home Healh Companion Services LLC,
• Psalms of Love Home Health Agency, LLC
• James P Psarras, M.D.
• Leah Georgea Psellas, PA-C
• John D Psenicska, LSW
• Alan G Psota, DDS
• Psychiatry Networks Inc
• Cara Ptak, PT, DPT
• Colleen M. Ptak, LISW-S
• Alyson Rita Pucci, PA

• Dentist in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.