Jaime Lyn Spaulding, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6772-015 Issued in WI

Practice address

3066 Shadyside Dr
Stoughton, WI 53589-3244

Phone

(715) 456-5148

NPI assigned

Sep 21, 2011

Last updated

Jun 16, 2022By the provider in NPPES

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

Other names 1

• Ms. Jaime Lyn Klebig Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Dane Dental LLC

  dba Dane Dental

  • Dental Clinic/Center
  • McFarland, WI
  • NPI 1760112247
  NPD Authorized official

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1144503715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 SHADYSIDE DR",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535893244",
            "telephone_number": "715-456-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 SHADYSIDE DR",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535893244",
            "telephone_number": "715-456-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAULDING",
        "first_name": "JAIME",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6772-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIME",
            "last_name": "KLEBIG",
            "middle_name": "LYN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary E Smith, RN
• Tenneh Moibah Soko, LPN
• Karen Sorenson-Lavalley, PA-C
• Kristi L Sorenson, RN
• Mychala R Spang, DC
• Carmen Sperle, LPC
• Stephanie Ann Spieker
• Rebecca Lynne Spinsky, PTA
• Daniel J Staddler, MD
• Shelby Ann Stapelfeldt, LPN

• General Practice Dentistry in Stoughton, WI
• Providers in Stoughton, 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 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.