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DR. DIANE MANNING PENNINGTON D.M.D., M.D.
NPI 1073695516
Dentist - Oral and Maxillofacial Surgery in Kingsland, GA

Active since October 20, 2006Opted out of Medicare · through Oct 17, 2027
1891 GA HIGHWAY 40 E, SUITE 1104, KINGSLAND, GA 31548(912) 673-6545(912) 576-1846 Get Directions Write a Review

NPPES record last updated: November 19, 2015. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Dr. Diane Manning Pennington D.m.d., M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DIANE MANNING PENNINGTON D.M.D., M.D. (NPI 1073695516) is an individual oral and maxillofacial surgery provider in Kingsland, Georgia, licensed in Georgia (DN011196) and active in the NPI registry since October 2006. She has opted out of Medicare through October 17, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1073695516
Entity TypeIndividualFemale
Primary Taxonomy1223S0112X
Provider Legal NameDR. DIANE MANNING PENNINGTONCredential: D.M.D., M.D.
Location Address1891 GA HIGHWAY 40 E, SUITE 1104Kingsland, GA 31548-6572
Mailing Address73 Hawthorn LnSaint Marys, GA 31558-4026 · (912) 673-6545 · Fax (612) 576-1846
Phone(912) 673-6545
Fax(912) 576-1846
Sole ProprietorNo
Enumeration DateOctober 20, 2006
Last NPPES UpdateNovember 19, 2015
✔ NPI 1073695516 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in GA · DN011196
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
1891 GA HIGHWAY 40 E, Kingsland, GA 31548
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Other Identifiers 1

Medicare UPINH97236

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Diane Manning Pennington D.m.d., M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 17, 2017 through October 17, 2027.

Opt-Out Effective DateOctober 17, 2017
Opt-Out In Effect ThroughOctober 17, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31548 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JULIE ANN WRIGHT O.D.
Optometrist
1891 GA HIGHWAY 40 E, SUITE 1108
KINGSLAND, GA 31548
Camden County (912) 576-8980
WRIGHT EYE CARE, P.C.
Optometrist
1891 GA HIGHWAY 40 E, SUITE 1108
KINGSLAND, GA 31548
Camden County (912) 576-8980

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Diane Pennington's NPI number?

The NPI number for Diane Pennington is 1073695516. It was assigned to this individual provider in the NPPES registry on October 20, 2006.

Where is Diane Pennington located?

Diane Pennington practices at 1891 Ga Highway 40 E Suite 1104, Kingsland, GA 31548. The listed phone number is (912) 673-6545.

What is Diane Pennington's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Diane Pennington enrolled in Medicare?

No. Diane Pennington has opted out of Medicare through October 17, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Diane Pennington accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 9 other insurers list Diane Pennington as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Diane Pennington was last updated on November 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.