Jonathan Daniel Boarini, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6001003-15 Issued in WI

Practice address

1111 Suffolk Dr
Janesville, WI 53546-1608

Phone

(608) 752-6848

NPI assigned

Jun 7, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Janesvillectd LLC

  • Dentist
  • Janesville, WI
  • NPI 1508533621
  NPD

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1114656063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30506 CEDAR DR",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531059109",
            "telephone_number": "262-206-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SUFFOLK DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535461608",
            "telephone_number": "608-752-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOARINI",
        "first_name": "JONATHAN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001003-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "frontdesk@janesvilledental.com",
            "affiliation": "Y",
            "affiliationName": "Cherry Tree Dental of Madison, LLC",
            "address_1": "8025 Excelsior Dr",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537171900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Beth Ann Blakeslee, M.D.
• Dan Blaser
• Leah Blazkovec, OTR
• Bloom Therapy and Wellness, LLC
• Diana M. Bloomberg, LICENSED PRACTICAL N
• Mark Boeche, D.D.S.
• Kathleen M. Boertman, OT
• Mark C Boettcher, MD
• Michele Renee Bohland, PTA
• Kristine Ann Bohrmueller, ARNP

• General Practice Dentistry in Janesville, WI
• Providers in Janesville, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; 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.