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General NPI Number Information
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NPI Number | 1861572661
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Entity Type | Individual
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Provider Name | RICHARD ERNEST JENNINGS DDS
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 6700 N 1ST ST SUTIE 110
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City | FRESNO
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State | CA
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Zip | 93710-3900
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Country | US
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Telephone | 559-435-4020
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Fax | 559-435-5571
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Provider Business Mailing Address
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Address Line | 6700 NORTH FIRST STREET SUTIE 110
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City | FRESNO
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State | CA
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Zip | 93710
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Country | US
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Telephone | 559-435-4020
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Fax | 559-435-5571
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 24921
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License Number State | CA
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