Active NPI
Diana Nguyen Jennings, DMD
- Dentist
- Charleston, SC
National Provider Identifier
1982124608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8935
- Practice address
- 29 Bee St
Charleston, SC 29425-0001 - Phone
- (843) 792-2101
- NPI assigned
- Jun 23, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8935 | SC | Primary |
Addresses
Primary practice location
29 Bee St
Charleston, SC 29425-0001
Mailing address
1421 Parkshore Dr
Charleston, SC 29407-3141
Phone (864) 590-1885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171019002525 | SC | Order and Referring Only - Dentist | 6002182961 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498176000000",
"number": "1982124608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1421 PARKSHORE DR",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294073141",
"telephone_number": "864-590-1885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BEE ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294250001",
"telephone_number": "843-792-2101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "DIANA",
"middle_name": "NGUYEN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-23",
"last_updated": "2017-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "8935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; 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.