Jacko & Siefker DDS, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JACKO & SIEFKER DDS, LLC

Doing business as

Wellington Dental

Practice address

210 Heritage Dr
Wellington, OH 44090-8949

Phone

(440) 647-2752

NPI assigned

Jul 8, 2020

Last updated

Jul 8, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan R Siefker, DDSNPI 1801818034

Title

Ceo

Phone

(440) 647-2752

Specialties & licenses 1

Addresses

Other names 1

• Wellington Dental Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jonathan R. Siefker, DDS

  • General Practice Dentistry
  • Wellington, OH
  • NPI 1801818034
  NPD Authorized official
• Maryann Jacko, DDS

  • General Practice Dentistry
  • Wellington, OH
  • NPI 1699797043
  NPD (past)
• Jennifer Latsko, DMD

  • General Practice Dentistry
  • Seville, OH
  • NPI 1285218586
  NPD (past)

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1245858083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 HERITAGE DR",
            "city": "WELLINGTON",
            "state": "OH",
            "postal_code": "440908949",
            "telephone_number": "440-647-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 HERITAGE DR",
            "city": "WELLINGTON",
            "state": "OH",
            "postal_code": "440908949",
            "telephone_number": "440-647-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKO & SIEFKER DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "SIEFKER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "440-647-2752",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellington Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Homebound Primary Care LLC
• Amanda Lane Horn, NP-C
• Martha Hoyt
• Jennifer Renee Hunter, RN
• Saadia Hussain, M.D
• Maryann Jacko, DDS
• Dana L Jeffers Jr.
• Eric Jessop
• Taylor Milton Johnson
• Kelly Lynne Keith

• Dental Clinic/Center in Wellington, OH
• Providers in Wellington, OH by specialty
• Dental Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.