Jordan Anne Bretsch, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.031400 Issued in IL

Practice address

Captain James a. Lovell Federal Health Care Center
3001 Green Bay Road
North Chicago, IL 60064

Phone

(847) 688-1900

NPI assigned

Sep 12, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1073032967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 N HALSTED ST APT 2916",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CAPTAIN JAMES A. LOVELL FEDERAL HEALTH CARE CENTER",
            "address_2": "3001 GREEN BAY ROAD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "60064",
            "telephone_number": "847-688-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETSCH",
        "first_name": "JORDAN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.031400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sami Bouzidi
• Jason Bowie, M.D.
• John Bozovich
• Ronald Walter Braasch Jr., PH.D.
• Alyssa Braithwaite
• Adrianna Brewton
• Ajla Brka
• Lejla Brka
• Karen Brodlo, BSN RN
• Cassidy Brooks

• General Practice Dentistry in North Chicago, IL
• Providers in North Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.