DR. JENNIFFER RENDON-VELASQUEZ (NPI# 1588159263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588159263 |
| Entity Type | Individual |
| Full Name | DR. JENNIFFER RENDON-VELASQUEZ |
| Credential | DMD |
| Practice Address |
3817 Gruber Rd Fort Bragg NC 28310-8925 |
| Mailing Address |
4027 Southern Oaks Dr Unit 2 Fayetteville NC 28314-0987 |
| Practice Telephone | 9103961571 |
| Mailing Telephone | 2014781046 |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2018-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
22DI02691100 | NJ | Dental Providers |
| Street Address |
3817 GRUBER RD |
| City | FORT BRAGG |
| State | NC |
| Zip Code | 28310-8925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837495 | Nicolette Paige Young | Dentist | 3817 Gruber Rd, Fort Bragg, NC 28310-8925 | 2020-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013550763 | Brent Francis Bachman | Physician Assistant | 2817 Reilly Street, Fort Bragg, NC 28310 | 2019-10-25 |
| 1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
| 1851959951 | Daniel Jordan Whitaker | Student in an Organized Health Care Education/Training Program | Womack Army Medical Center, 2817 Reilly Road, Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2019-06-03 |
| 1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
| 1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
| 1457843831 | Kevin Patrick Hudson | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road Mxcx - Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2018-06-01 |
| 1639691462 | Margaret S Greene | Dentist | Usa Dental Health Activity Fort Bragg, Wamc Box #151 2817 Rielly Rd, Fort Bragg, NC 28310 | 2017-07-13 |
| 1912432246 | Chezdan Baker | Student in an Organized Health Care Education/Training Program | Us Army Dental Health Activity Bldg-6837 Normandy Drive, Fort Bragg, NC 28310 | 2017-04-24 |
| 1215483094 | Shantryce Monique Boatwright Crump | Dental Hygienist | 2617 Rielly Road, Fort Bragg, NC 28310 | 2016-08-31 |
| 1629435714 | John Gagnier | Physician Assistant | Gruber Road, Building #c-1722, Fort Bragg, NC 28310 | 2016-01-21 |
| Find all providers in zip 28310 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750997110 | William James Graham Iv | Dentist | Bldg B-6837 Normandy Dr, Fort Bragg, NC 28310-0001 | 2020-09-21 |
| 1679194906 | Jeff Bertheola | Dentist | 825 Sequoia Cir, Fort Bragg, CA 95437-5422 | 2020-04-27 |
| 1114572229 | Amanda C Blankenship | Dentist | Smoke Bomb Hill Dental Clinic 3817 Gruber Rd, Fort Bragg, NC 28310-0001 | 2019-08-06 |
| 1831754795 | Ryan David Smith | Dentist | Bldg 4681 Logistics Ave, Fort Bragg, NC 28310-0001 | 2019-05-07 |
| 1912423377 | Lejla Streets | Dentist | 2827 Reilly Rd, Fort Bragg, NC 28310-0001 | 2017-08-17 |
| 1033635420 | Andrew Seun | Dentist | Bldg 6837 Normandy Drive, Fort Bragg, NC 28310-0001 | 2017-08-17 |
| 1184144479 | Thomas William Hanna IIi | Dentist | Bldg C-6238 Ardennes St., Fort Bragg, NC 28307 | 2017-06-27 |
| 1598134769 | Sidney Choi | Dentist | 499 E Chestnut St, Fort Bragg, CA 95437-4913 | 2015-09-17 |
| 1083048706 | Gamal Ahmad Baker | Dentist | Logisitcs Ave Bldg M-4861, Us Army Dental Activity, Fort Bragg, NC 28310-7302 | 2013-08-29 |
| 1700227576 | Neil Steven Wilensky | Dentist | 895 River Dr, Fort Bragg, CA 95437-5441 | 2013-07-09 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 28310 |
Please comment or provide details below to improve the information on DR. JENNIFFER RENDON-VELASQUEZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.