NPIMap

Organization Active NPI

Area Oms

  • Oral and Maxillofacial Surgery (Dentist)
  • Beaver Dam, WI
National Provider Identifier
1306615380
Registry record updated Jan 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
AREA OMS
Practice address
301 S Roosevelt Dr
Beaver Dam, WI 53916-2439
Phone
(920) 365-9711
NPI assigned
Jan 1, 2024
Last updated
Jan 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2024

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

Authorized official

Name
Dr. Jarrod Thomas, DDSNPI 1427293620
Title
President
Phone
(920) 261-0495

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU Primary

Addresses

Primary practice location

301 S Roosevelt Dr
Beaver Dam, WI 53916-2439

Mailing address

301 S Roosevelt Dr
Beaver Dam, WI 53916-2439
Phone (920) 365-9711

National Provider Directory

National Provider Directory

Locations

1149 Boughton St
#B
Watertown, WI 53094
Phone (920) 261-0495

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1704067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704067200000",
    "number": "1306615380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S ROOSEVELT DR",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162439",
            "telephone_number": "920-365-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S ROOSEVELT DR",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162439",
            "telephone_number": "920-365-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AREA OMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-01",
        "last_updated": "2024-01-01",
        "certification_date": "2024-01-01",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "JARROD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-261-0495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2024; 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.