NPIMap

Organization Active NPI

J.L. Mackman DDS

  • General Practice Dentistry
  • Wauwatosa, WI
National Provider Identifier
1457472441
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2793 Issued in WI
Legal business name
J.L. MACKMAN DDS
Practice address
2626 N Wauwatosa Ave
Wauwatosa, WI 53213-1137
Phone
(414) 476-9400
Fax
(414) 962-9599
NPI assigned
Apr 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jay L MackmanNPI 1821194184
Title
Dentist
Phone
(414) 476-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2793 WI Primary

Addresses

Primary practice location

2626 N Wauwatosa Ave
Wauwatosa, WI 53213-1137

Mailing address

2626 N Wauwatosa Ave
Wauwatosa, WI 53213-1137
Phone (414) 476-9400

National Provider Directory

National Provider Directory
Tax ID family
Jay L Mackman DDS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2626 N Wauwatosa Ave
Wauwatosa, WI 53213
Phone (414) 476-9400

Practitioners & affiliated clinicians

Practitioners 1

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457472441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 N WAUWATOSA AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532131137",
            "telephone_number": "414-476-9400",
            "fax_number": "414-962-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 N WAUWATOSA AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532131137",
            "telephone_number": "414-476-9400",
            "fax_number": "414-962-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.L. MACKMAN DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACKMAN",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "414-476-9400",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "2793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.