Healthcare Provider Details

I. General information

NPI: 1699062208
Provider Name (Legal Business Name): JENNIFER R DINNING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2011
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 LAKELAND DR STE 43
JACKSON MS
39216-4634
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 601-200-2990
  • Fax: 601-200-5939
Mailing address:
  • Phone: 601-200-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberT-2426
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number24720
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: