Jake Stewart Starr, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2087 Issued in MT

Practice address

1101 Maryland Ave
Deer Lodge, MT 59722-1806

Phone

(406) 846-3532

Fax

(406) 846-1885

NPI assigned

Jul 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 19, 2016 through May 19, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265465967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MARYLAND AVE",
            "city": "DEER LODGE",
            "state": "MT",
            "postal_code": "597221806",
            "telephone_number": "406-846-3532",
            "fax_number": "406-846-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MARYLAND AVE",
            "city": "DEER LODGE",
            "state": "MT",
            "postal_code": "597221806",
            "telephone_number": "406-846-3532",
            "fax_number": "406-846-1885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARR",
        "first_name": "JAKE",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "2087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0113016",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renee' Marie Schoening, L.C.P.C.
• Bailee Senecal, OTD, OTR/L
• Eric Shane Spears, MPT
• Dale A Speiser, D.C.
• Amanda Spell, RDH
• Kimberly J Stavlo, SLP
• Killian Locke Thomas, LCSW
• Patrick R Waber, MD
• Ronda L Wangerin, P.T.
• Judith H Wilson, MD

• General Practice Dentistry in Deer Lodge, MT
• Providers in Deer Lodge, MT by specialty
• General Practice Dentistry in Montana

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.