Active NPI
Jacob Briese, DDS
- Dentist
- Marshfield, WI
National Provider Identifier
1346734035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1001858-15
- Practice address
- 306 W McMillan St
Marshfield, WI 54449-6013 - Phone
- (715) 387-1702
- NPI assigned
- Jun 18, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1001858-15 | WI | Primary |
Addresses
Primary practice location
306 W McMillan St
Marshfield, WI 54449-6013
Mailing address
306 W McMillan St
Marshfield, WI 54449-6013
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 27, 2021 through Jul 27, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1001858-15 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Clinic of Marshfield SC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Marshfield, WI
- NPI 1699724815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529280000000",
"number": "1346734035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 W MCMILLAN ST",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544496013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 W MCMILLAN ST",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544496013",
"telephone_number": "715-387-1702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIESE",
"first_name": "JACOB",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-18",
"last_updated": "2018-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "1001858-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.