Individual
DR. KEVIN D JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
211 PROVIDENCE RD, SUITE 11, CHESAPEAKE, VA 23325-4687
(757) 523-9002
(757) 523-9005
Mailing address
211 PROVIDENCE RD, SUITE 11, CHESAPEAKE, VA 23325-4687
(757) 523-9002
(757) 523-9005
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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