Jessica L Kiecker, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

6337 Issued in WI

Practice address

1532 W Broadway Ste 101
Monona, WI 53713-1827

Phone

(608) 221-3326

Fax

(608) 221-9726

NPI assigned

Jan 27, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Great Day Dental LLC

  • Dental Clinic/Center
  • Monona, WI
  • NPI 1740792969
  NPD Authorized official
• Great Day Dental LLC

  • Dental Clinic/Center
  • Madison, WI
  • NPI 1992217053
  NPD Authorized official

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1306084553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 W BROADWAY STE 101",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537131827",
            "telephone_number": "608-221-3326",
            "fax_number": "608-221-9726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 W BROADWAY STE 101",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537131827",
            "telephone_number": "608-221-3326",
            "fax_number": "608-221-9726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2010 Eastwood Dr Ste 203",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537045387",
            "country_code": "US",
            "telephone_number": "608-241-1579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIECKER",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-27",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE NPI MONONA",
            "identifier": "1740792969",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE NPI EAST",
            "identifier": "1992217053",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Lee Katcher, LCSW, SACIT
• Leeann Katzfey
• Pamela Ann Keating, RN
• Diane Marie Kelley, MSN, ANP-BC APNP
• Rachel A Kelley
• Rebecca J Kienbaum, CAPSW
• James E Kilgore, CSAC, ICS
• Jennifer R Klawitter, LPC, SAC
• Robert Charles Knutson, D.D.S.
• Chelsi Koenig

• Dentist in Monona, WI
• Providers in Monona, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.