MEDICARE: DR. TERRANCE DALE JENNINGS DDS

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	122300000X	Dentist	1955	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	58316	OTHER		BLUE CROSS FEDERAL
2	835361	OTHER	AR	BLUE CROSS STATE

General Provider Information

NPI Number	:	1780769844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRANCE DALE JENNINGS DDS

Provider Business Mailing Address
First Line	:	2910 JENNY LIND ROAD
Second Line	:	SUITE 7
City	:	FORT SMITH
State	:	AR
Zip	:	72901-6733
Country	:	US
Telephone Number	:	479-785-4107
Fax Number	:	479-494-7638

Provider Business Practice Location Address
First Line	:	2910 JENNY LIND ROAD
Second Line	:	SUITE 7
City	:	FORT SMITH
State	:	AR
Zip	:	72901-6733
Country	:	US
Telephone Number	:	479-785-4107
Fax Number	:	479-494-7638

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1124589536 — PALLIATIVE CARE AT HEART, LLC
Practice Location Address:

2910 JENNY LIND RD STE 4
FORT SMITH, AR
72901-6733

Practice Phone: 800-752-0444
Practice Fax:

1851921621 — JONATHAN JOSEPH BROWN PTA
Practice Location Address:

2910 JENNY LIND RD STE 9A
FORT SMITH, AR
72901-6733

Practice Phone: 479-494-7273
Practice Fax:

1942288824 — MS. TRACY SHERMAN PHD, CCC-SLP
Practice Location Address:

963 HOLBROOK CIR
FORT WALTON BEACH, FL
32547-6733

Practice Phone: 850-503-4071
Practice Fax: 850-999-7451

1477817781 — KIMBERLY WARD M.S.
Practice Location Address:

6733 CLEAR SPRING DR
FORT WORTH, TX
76132-3750

Practice Phone: 817-300-1920
Practice Fax:

1245765585 — CROSSROADS TREATMENT CENTER OF FORT WORTH, PLLC
Practice Location Address:

6733 CAMP BOWIE BLVD
FORT WORTH, TX
76116-7112

Practice Phone: 817-386-9180
Practice Fax:

1871097634 — CLETIS HUBBARD
Practice Location Address:

6733 CAMP BOWIE BLVD
FORT WORTH, TX
76116-7112

Practice Phone: 817-386-9180
Practice Fax:

Directions to “ DR. TERRANCE DALE JENNINGS DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.