Jake Madsen, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9809328-9922 Issued in UT

Practice address

652 Hamilton Rd.
Fort Sill, OK 73503

Phone

(580) 442-3905

NPI assigned

Sep 1, 2016

Sex

Male

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": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1134675747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 HAMILTON RD.",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "73503",
            "telephone_number": "580-442-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 HAMILTON RD.",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "73503",
            "telephone_number": "580-442-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADSEN",
        "first_name": "JAKE",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "9809328-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anson Lukose, M.D.
• Edward Wayne Lumpkins, D.D.S.
• Linda Carolyn Lynch, DPH
• Kerry R Macdonald, MPT
• Scott Anthony Maddox, R.N.
• Joshua Harlin Mallow, PHARM D.
• Stephen Patrick Manley, PA-C
• Rodrigo Alba Mariano, MD
• Melissa Marshall, EFDA
• Bailey Martin

• General Practice Dentistry in Fort Sill, OK
• Providers in Fort Sill, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.