MEDICARE: CHET JENKINS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0001X	Public Health Dentistry

General Provider Information

NPI Number	:	1760325187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHET JENKINS PC

Provider Business Mailing Address
First Line	:	410 N 44TH ST STE 600
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-7616
Country	:	US
Telephone Number	:	480-234-8490
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 UNION AVE SE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98501-1545
Country	:	US
Telephone Number	:	360-943-6111
Fax Number	:

Authorized Official
Title or Position	:	VP OF TRAINING AND INTEGRATIONS
Name	:	MELODY BENNION
Credential	:
Telephone Number	:	480-234-8490

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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