JACKSON FAMILY DENTISTRY LLC (NPI# 1114317815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114317815 |
Entity Type | Organization |
Organization Name | JACKSON FAMILY DENTISTRY LLC |
Practice Address |
N168w20060 Main St Jackson WI 53037-9382 |
Practice Telephone | 2626773003 |
Practice Fax Number | 2626771641 |
Mailing Telephone | 2626773003 |
Mailing Fax Number | 2626771641 |
Enumeration Date | 2015-02-02 |
Last Update Date | 2015-02-02 |
Authorized Official Name | DR. SCOTT WILLIAM CHARMOLI (OWNER) |
Authorized Official Telephone | 2626773003 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
3671-15 | WI | Dental Providers |
Street Address |
N168W20060 MAIN ST |
City | JACKSON |
State | WI |
Zip Code | 53037-9382 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417171018 | Aurora Medical Group, Inc. | Family Medicine | N168w20060 Main St, Jackson, WI 53037-9382 | 2007-04-13 |
1679928188 | Benjamin Charles Heffter | Dentist | N168w20060 Main St, Jackson, WI 53037-9380 | 2016-05-03 |
1720386634 | Aurora Advanced Healthcare, Inc. | Durable Medical Equipment & Medical Supplies | N168w20060 Main St, Jackson, WI 53037-9382 | 2011-03-02 |
1003116278 | Pako M Major | Dentist | N168w20060 Main St, Jackson, WI 53037-9380 | 2010-10-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598377905 | Nohc Jackson Senior Living LLC | Assisted Living Facility | N16744 Eagle Drive, Jackson, WI 53037 | 2020-08-18 |
1467996991 | Children's Medical Group | Pediatrics | N168w22730 Prairie View Lane, Jackson, WI 53037 | 2016-12-19 |
1700176682 | Lincoln Healthcare, Inc | Home Health | W227n16841 Tillie Lake Court, Jackson, WI 53037 | 2011-04-13 |
1023211380 | Laura Jean Steinmetz | Licensed Practical Nurse | N170 W20309 Hunters Rd, Jackson, WI 53037 | 2007-06-06 |
1073722724 | Peter Christian Labudde | Dentist | N168 W20566 Main St, Jackson, WI 53037 | 2007-05-21 |
1104952597 | Judith Barbara Miller | Registered Nurse | 3114 Sherman Parc Circle, Jackson, WI 53037 | 2007-02-27 |
1548395684 | Joan Alice Heath | Registered Nurse | N168w21700 Main St Lot 122, Jackson, WI 53037 | 2007-02-22 |
1578511739 | Carol Lynn Radovich | Nurse Practitioner | W197n17054 Stonewall Dr, Jackson, WI 53037 | 2006-05-04 |
1699752907 | Zhaleh Barari | Optometrist | W194 N 16747 Eagle Dr., Suite N, Jackson, WI 53037 | 2005-12-28 |
1790399780 | Jackson Town & Country Dental LLC | Dentist | N168 W20566 Main St, Jackson, WI 53037 | 2020-09-07 |
Find all providers in zip 53037 |
Taxonomy Code | 1223G0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | General Practice |
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
Notes: Source: Academy of General Dentistry |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518584952 | Katherine Olivia Hughes | Dentist | 1189 Vann Dr, Jackson, TN 38305-6098 | 2020-07-01 |
1144845991 | Gregory Derrick Meredith | Dentist | 190 Water St Ste 2, Jackson, OH 45640-1384 | 2020-06-08 |
1033771852 | Robert E Scheddin | Dentist | 2046 W County Line Rd Ste 2, Jackson, NJ 08527-2034 | 2019-07-01 |
1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
1780145912 | Dr Lashawn Steptoe Family Dentistry | Dentist | 500 E Woodrow Wilson Ave Ste N, Jackson, MS 39216-4538 | 2019-03-29 |
1720571334 | Christina Holy Mcrae | Dentist | 3000 Old Canton Rd Ste 515, Jackson, MS 39216-4235 | 2018-06-08 |
1275024192 | Brianne Elizabeth Mezo | Dentist | 1500 W Parnall Rd, Jackson, MI 49201-8660 | 2018-05-26 |
1407343254 | West Tennessee Dentistry Pllc | Dentist | 1108 Whitehall St, Jackson, TN 38301-3730 | 2018-04-17 |
1073014338 | Helping Hands of Middle & West Tennessee | Dentist | 1408 N Highland Ave Ste 101, Jackson, TN 38301-3450 | 2018-02-22 |
1942730429 | Patrice Nicole Griffith | Dentist | 1189 E County Line Rd Ste 1010, Jackson, MS 39211-1836 | 2017-06-15 |
Find all providers in JACKSON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.