Individual provider Active NPI

Jessica Joy Schwantes, DDS

  • Dentist
  • Madison, WI
National Provider Identifier
1245559558
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6508-15 Issued in WI
Practice address
3434 E Washington Ave
Madison, WI 53704-4155
Phone
(608) 443-5482
Fax
(608) 443-5570
NPI assigned
May 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6508-15 WI Primary

Addresses

Primary practice location

3434 E Washington Ave
Madison, WI 53704-4155

Mailing address

2901 W Beltline Hwy
Suite 120
Madison, WI 53713-4226
Phone (608) 443-5500

Other identifiers 1

IdentifierTypeStateIssuer
1245559558MedicaidWI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151231001962 WI Order and Referring Only - DentistPractitioner - Dentist 4082916440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1245559558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W BELTLINE HWY",
            "address_2": "SUITE 120",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537134226",
            "telephone_number": "608-443-5500",
            "fax_number": "608-441-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044155",
            "telephone_number": "608-443-5482",
            "fax_number": "608-443-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWANTES",
        "first_name": "JESSICA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-26",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6508-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245559558",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.