Jan L Seubert, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3967 Issued in WI

Practice address

260 W Cook St
Portage, WI 53901-2106

Phone

(608) 742-2331

Fax

(608) 742-4308

NPI assigned

Apr 24, 2007

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

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Seubert Family Dentistry, LLC

  • General Practice Dentistry
  • Portage, WI
  • NPI 1366848509
  NPD (past) Authorized official
• Currani Seubert Dental Office LLC

  • General Practice Dentistry
  • Portage, WI
  • NPI 1710083779
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154540615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 W COOK ST",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539012106",
            "telephone_number": "608-742-2331",
            "fax_number": "608-742-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 W COOK ST",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539012106",
            "telephone_number": "608-742-2331",
            "fax_number": "608-742-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEUBERT",
        "first_name": "JAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Schultz, DPT
• Jonathan J Schulz, MSE
• Lori A Schumann, PT
• Service Drugs
• Seubert Family Dentistry, LLC
• Mitchell Seubert, D.D.S.
• Sara B Shaver, LMFT
• Kali L Shepard, OTR
• Samantha Ann Shields, COTA
• Shoptikal LLC

• General Practice Dentistry in Portage, WI
• Providers in Portage, 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 Jul 8, 2007; 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.