Jedidiah L Janisse DMD and Associates, LTD

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

JEDIDIAH L JANISSE DMD AND ASSOCIATES, LTD

Practice address

217 Maxham Meadow Way # 10
Suite 4C
Woodstock, VT 05091-1162

Phone

(802) 457-1903

Fax

(802) 457-3619

NPI assigned

Dec 17, 2008

Last updated

Oct 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jedidiah L Janisse, DMD

Title

President

Phone

(802) 457-1903

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mona Elzarka, DMD

  • General Practice Dentistry
  • Canaan, NH
  • NPI 1144454760
  NPD (past)

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570752000000",
    "number": "1083850374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 MAXHAM MEADOW WAY # 10",
            "address_2": "SUITE 4C",
            "city": "WOODSTOCK",
            "state": "VT",
            "postal_code": "050911162",
            "telephone_number": "802-457-1903",
            "fax_number": "802-457-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 MAXHAM MEADOW WAY # 10",
            "address_2": "SUITE 4C",
            "city": "WOODSTOCK",
            "state": "VT",
            "postal_code": "050911162",
            "telephone_number": "802-457-1903",
            "fax_number": "802-457-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEDIDIAH L JANISSE DMD AND ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-17",
        "last_updated": "2019-10-11",
        "status": "A",
        "authorized_official_last_name": "JANISSE",
        "authorized_official_first_name": "JEDIDIAH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "802-457-1903",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016-0002247",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Health Care and Rehabilitation Services of Southeastern Vermont, Inc.
• Heart of the Greens PLLC
• Hugh P Hermann, M.D.
• Hugh P. Hermann, M.D.
• Margaret Nassym Janisse, DMD
• Sandra Louise Josin, RDH, CPHDH
• Mark David Knott, D.D.S.
• Kenneth Krauss, PHARM
• Cathleen Marie Kwiecinski, M.A., LCMHC
• Dianne Langona, MSW, LICSW

• Oral and Maxillofacial Surgery Clinic/Center in Woodstock, VT
• Providers in Woodstock, VT by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.