Jarrod Bruce Thomas, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6258-15 Issued in WI

Practice address

1149 Boughton St
Area Dental Clinic
Watertown, WI 53094-3104

Phone

(920) 261-0495

NPI assigned

Dec 3, 2008

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

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

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.

• Area Oms

  • Oral and Maxillofacial Surgery (Dentist)
  • Beaver Dam, WI
  • NPI 1306615380
  NPD (past) Authorized official

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247097600000",
    "number": "1427293620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 BOUGHTON ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530943104",
            "telephone_number": "920-261-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 BOUGHTON ST",
            "address_2": "AREA DENTAL CLINIC",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530943104",
            "telephone_number": "920-261-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JARROD",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-03",
        "last_updated": "2009-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6258-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Promporn June Suwanabol
• Zachary Thomas Sweatman, ATC
• Bethann Marie Swisher, PHARMD
• Kenneth Russell Tennessen, PHARMD
• Kimberly Ann Theisen, PTS
• Todd a. Sandstrom, MD, SC
• Jeffrey J Tolsma, LMT
• Danielle G. Tonelli, DO
• Total Renal Care Inc
• Hannah Tremaine

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.