Individual
DR. DAVID R JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
4374015
WI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8761
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DE00006557
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6B297JE
BC/BS OF MN GROUP #
MN
01
—
6B298JE
BC/BS OF MN PROVIDER #
MN
01
—
761075
UNITED CONCORDIA PROVIDER
MN
01
—
DB2954
RAILROAD MEDICARE GROUP #
MN
01
—
HP38841
HEALTH PARTNERS
MN
Enumeration date
06/17/2005
Last updated
07/16/2007
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