Dr. Molly Ann Jenkins, DDS
Dentist, General Practice in Great Lakes, IL. Individual provider (NPI-1).
NPI number1104802115
StatusActive
Last updated in NPPESJul 13, 2026
Details
- NPI
- 1104802115
- Entity type
- Individual (NPI-1)
- Name
- Dr. Molly Ann Jenkins
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 21, 2005
- Last updated
- Jul 13, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 19433 | TX | Yes |
Practice location
3001 6th StSte A
Great Lakes, IL 60088-2833
Phone 847-688-2100
Mailing address
1330 S White Oak Dr#523
Waukegan, IL 60085-8374
Phone 847-688-2100
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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