Jaclyn M Winner, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.023509 Issued in OH

Practice address

1021 N Main St
Bellefontaine, OH 43311-2359

Phone

(937) 292-7828

Fax

(937) 292-7916

NPI assigned

Jun 27, 2011

Sex

Female

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 OH

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.

• Champaign Dental Group, Inc.

  • Dentist
  • Urbana, OH
  • NPI 1598771321
  NPD (past)
• Limazwick - Bellefontaine, LLC

  • Dental Clinic/Center
  • Bellefontaine, OH
  • NPI 1003453432
  NPD (past)
• Limazwick-Urbana LLC

  • General Practice Dentistry
  • Urbana, OH
  • NPI 1629615794
  NPD (past)
• Logan Dental Care LLC

  • General Practice Dentistry
  • Bellefontaine, OH
  • NPI 1326116369
  NPD (past)

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1699061788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 PATRICK AVE",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "430782123",
            "telephone_number": "937-653-8650",
            "fax_number": "937-653-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 N MAIN ST",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112359",
            "telephone_number": "937-292-7828",
            "fax_number": "937-292-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINNER",
        "first_name": "JACLYN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.023509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie A Wilcox, LSW
• Keith David Wiley, R.PH
• Elise Williams
• Kathrine Williams, M.A., LPCC
• Sarah Willoby
• Brett Wisner
• Edwin George Wisner, AT
• Esther Viola Witmer, LISW
• Jennifer Joyce Wooley, OTR L
• Emily K Wulf

• General Practice Dentistry in Bellefontaine, OH
• Providers in Bellefontaine, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.