Active NPI
Curtis J Jelinek, DDS
- General Practice Dentistry
- Mequon, WI
National Provider Identifier
1245321355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3390-015
- Practice address
- 11415 N Bobolink LN
Mequon, WI 53092-3006 - Phone
- (262) 238-9868
- Fax
- (262) 238-9474
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3390-015 | WI | Primary |
Addresses
Primary practice location
11415 N Bobolink LN
Mequon, WI 53092-3006
Mailing address
11415 N Bobolink LN
Mequon, WI 53092-3006
Phone (262) 238-9868
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3390-015 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258588800000",
"number": "1245321355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11415 N BOBOLINK LN",
"city": "MEQUON",
"state": "WI",
"postal_code": "530923006",
"telephone_number": "262-238-9868",
"fax_number": "262-238-9474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11415 N BOBOLINK LN",
"city": "MEQUON",
"state": "WI",
"postal_code": "530923006",
"telephone_number": "262-238-9868",
"fax_number": "262-238-9474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JELINEK",
"first_name": "CURTIS",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2009-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "3390-015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.