Jacquelyn Rae Schieck, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D13177 Issued in MN

Practice address

1531 Clinton LN
Northfield, MN 55057-3295

Phone

(507) 581-8575

Fax

(507) 216-6042

NPI assigned

Aug 19, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jacquelyn Rae Kolbeck Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 23, 2016 through Mar 23, 2028

Medicare enrollment (NPD)

Not 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.

• Schieck Orthodontics, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Northfield, MN
  • NPI 1407275613
  NPD (past) Authorized official
• Smile Doctors of Minnesota PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Albert Lea, MN
  • NPI 1255974325
  NPD (past)

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1518273200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 CLINTON LN",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573295",
            "telephone_number": "507-581-8575",
            "fax_number": "507-216-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 CLINTON LN",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573295",
            "telephone_number": "507-581-8575",
            "fax_number": "507-216-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIECK",
        "first_name": "JACQUELYN",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "SD",
            "license": "TEMP287",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "D13177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "KOLBECK",
            "middle_name": "RAE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Joshua Sand, ATC
• Heather Sue Sayler, CNP
• Ashley Elizabeth Scharping, PA
• Michelle Marie Scheglowski
• Schieck Orthodontics, PLLC
• Patricia Schilling
• Gregory Scott Schlichter, LPCC
• John Richert Schnorr, CCC/SLP
• Colleen Schuda Larson, OT/L
• Heather Jean Scott, CCC-SLP

• Orthodontics and Dentofacial Orthopedics Dentistry in Northfield, MN
• Providers in Northfield, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.