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Individual
DR. KEVIN D JENNINGS
Active
Individual
DR. KEVIN D JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6444
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005596256
AETNA
VA
05
—
0006147
—
VA
01
—
028603
BLUE CROSS BLUE SHIELD
VA
01
—
6444
DELTA DENTAL OF VA
VA
01
—
831824
UNITED CONCORDIA
VA
Enumeration date
10/26/2005
Last updated
02/04/2008
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