Thomas R Jazwiecki, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

6413-15 Issued in WI

Practice address

8241 S Howell Ave
Oak Creek, WI 53154-8346

Phone

(414) 939-1024

Fax

(414) 762-5974

NPI assigned

Jun 12, 2009

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1528295920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8241 S HOWELL AVE",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531548346",
            "telephone_number": "414-939-1024",
            "fax_number": "414-762-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8241 S HOWELL AVE",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531548346",
            "telephone_number": "414-939-1024",
            "fax_number": "414-762-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAZWIECKI",
        "first_name": "THOMAS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-12",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6413-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian L Jan, PA-C
• Anisa Janko
• Ryan Janus, NRP
• Lee Eliot Jastrow, PHARMD
• Jane Jaszewski, MSW, LMFT
• Steven J Jereb, M.D.
• JK Medical Corp
• Jacob Johnson
• Stephanie Johnson, PT
• Carly Jones

• Dentist in Oak Creek, WI
• Providers in Oak Creek, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.