DR. ANDREW JENZER (NPI# 1720497001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720497001 |
| Entity Type | Individual |
| Full Name | DR. ANDREW JENZER |
| Credential | DDS |
| Practice Address |
1631 Gordon Hwy Augusta GA 30906-2292 |
| Mailing Address |
1120 15th St Ste Bi1056 Augusta GA 30912-0004 |
| Practice Telephone | 8025794904 |
| Mailing Telephone | 7067213813 |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2020-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 7173 | NE | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
DN015870 | GA | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DN015870 | GA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1430 John Wesley Gilbert Drive, Augusta, GA 309122292 | 7067212696 | |
| 1631 Gordon Hwy, Augusta, GA 309062292 | 8025794904 | |
| 300 W Hospital Rd, Fort Gordon, GA 30905 | 8025794904 |
| Street Address |
1631 GORDON HWY |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30906-2292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306811914 | Terrence L Vandiver | Dentist | 1631 Gordon Hwy, #22, Augusta, GA 30906-2292 | 2006-02-18 |
| 1215487467 | Gordon Highway Dental Group, LLC | Dentist | 1631 Gordon Hwy, Augusta, GA 30906 | 2016-10-12 |
| 1255408456 | Vinh Tu Vuong | Dentist | 1631 Gordon Hwy, #22, Augusta, GA 30906-2292 | 2006-11-30 |
| 1194784314 | Total Renal Care Inc | Clinic/Center | 1631 Gordon Hwy, Ste 1b, Augusta, GA 30906 | 2006-03-17 |
| 1033184643 | Augusta Smiles Youth Dentistry, PC | Dentist | 1631 Gordon Hwy, Suite #22, Augusta, GA 30906-2292 | 2006-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969432 | Barton Chapel Dental Group, LLC | Dentist | 2755 Barton Chapel Road, Augusta, GA 30906 | 2020-04-01 |
| 1255897419 | Pediatric Mobility Innovations | Durable Medical Equipment & Medical Supplies | 3114 Augusta Tech Drive Suite 404, Augusta, GA 30906 | 2019-02-13 |
| 1023539731 | Kristy Lee Gibbs | Registered Nurse | 3421 Mike Padgett Hwy Bldg C, Augusta, GA 30906 | 2017-07-03 |
| 1194186031 | Clifton Nane Williams | Counselor | 3230 Hampton Circle, Augusta, GA 30906 | 2016-03-18 |
| 1376929661 | Catherine A. Ganzy | Social Worker | 3405 Mike Padgett Highway; Building 201, East Central Regional Hosptial, Augusta, GA 30906 | 2015-08-10 |
| 1962810358 | Fatemeh Azadeh Paziraei | Dentist | 1631 Gordon Highway, Augusta Smiles Youth Dentistry, Augusta, GA 30906 | 2014-07-29 |
| 1568809770 | Brandon Jennings | Occupational Therapy Assistant | 2388 Old Mcduffie Rd, Augusta, GA 30906 | 2013-05-29 |
| 1811266646 | Eddie P Johnson IIi, Dmd, PC | Preferred Provider Organization | 2755 Barton Chapel Rd, Augusta, GA 30906 | 2011-12-23 |
| 1366739021 | Kerensa A Cooks | Registered Nurse | 3421 Mike Padgett Highway, Serenity Behavioral Health Systems, Augusta, GA 30906 | 2011-07-01 |
| 1265737423 | Pidcock Chiropractic, Inc. | Chiropractor | 3028 Peach Orchard Rd., Augusta, GA 30906 | 2011-01-20 |
| Find all providers in zip 30906 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558795930 | Terry R. Ellis, Dmd, PC | Dentist | 1244 Augusta West Pkwy, Augusta, GA 30909-1854 | 2013-08-21 |
| 1831455732 | Rebecca Lynne Paquin | Dentist | Mcg Department of Otolaryngology-head and Neck Surgery, 1120 15th Street, Suite Bp 4109, Augusta, GA 30912 | 2012-04-04 |
| 1487883815 | Sara Khaled Akeel | Dentist | 705 Saint Andrews Drive, Augusta, GA 30909 | 2009-07-07 |
| 1407070006 | Facial and Oral Surgery Associates | Dentist | 5 Community Dr, Augusta, ME 04330-8087 | 2007-04-13 |
| 1790715142 | R. Robert Berube | Dentist | Facial & Oral Surgery Associates, Pa, 5 Community Drive, Augusta, ME 04330 | 2006-07-03 |
| 1093744294 | Edwin Douglas Joy Jr. | Dentist | 1222 George C Wilson Dr, Augusta, GA 30909-4502 | 2006-07-01 |
| 1548205636 | Drs. Peacock & Rafoth, P.C. | Dentist | 3634 Wheeler Rd, Augusta, GA 30909-6518 | 2006-06-20 |
| 1790724763 | Samuel Christopher D'arco | Dentist | 3736 Walton Way Ext, Augusta, GA 30907-2402 | 2006-06-05 |
| 1255307831 | Terry Randal Ellis | Dentist | 1244 Augusta West Parkway, Augusta, GA 30909 | 2006-02-24 |
| 1275195984 | Anh Nguyen | Dentist | 1430 John Wesley Gilbert Drive, Augusta, GA 30912-5042 | 2019-07-02 |
| Find all providers in AUGUSTA | ||||
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| 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.