Jason T Skinner, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

07996 Issued in IA

Practice address

102 N 5TH St
Clear Lake, IA 50428-1803

Phone

(641) 357-4112

Fax

(641) 357-0670

NPI assigned

Nov 8, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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

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.

• Skinner Family Dentistry, PC

  dba Skinner Family Dentistry

  • General Practice Dentistry
  • Mankato, MN
  • NPI 1083397244
  NPD Authorized official
• Lake Dental Associates PC

  • General Practice Dentistry
  • Clear Lake, IA
  • NPI 1265511950
  NPD (past) Authorized official
• Bieber Dental PLLC

  dba Lake Dental Associates

  • Dental Clinic/Center
  • Clear Lake, IA
  • NPI 1568231280
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1689744898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N 5TH ST",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281803",
            "telephone_number": "641-357-4112",
            "fax_number": "641-357-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N 5TH ST",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281803",
            "telephone_number": "641-357-4112",
            "fax_number": "641-357-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "JASON",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "07996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0205708",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Connie Jeane Scherber
• Sable Mae Schwartz
• Mark J Scribbins, DDS
• Jon Secory, RPH
• Amanda Rae Setterholm, RBT
• Jacob Dean Sorensen, DDS
• Lexa Collin Starbeck, ARNP
• Jenna Jean Stoltenberg, RBT
• Valerie Tichy, LMHC
• Dezarae Serah Till

• General Practice Dentistry in Clear Lake, IA
• Providers in Clear Lake, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.