Jeffrey D Nielsen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5002113 Issued in WI

Practice address

3144 Van Zile Rd.
Crandon, WI 54520-9001

Phone

(715) 478-5180

NPI assigned

Mar 3, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290556800000",
    "number": "1700915170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 GRUBER ST",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092525",
            "telephone_number": "715-623-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3144 VAN ZILE RD.",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545209001",
            "telephone_number": "715-478-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-03",
        "last_updated": "2010-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5002113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen A Minx, SAC
• Susan Elisabeth Moore, MD
• Frank Mraz, MD
• Newcap, Inc.
• Aubrey Leigh D Newton, LPC
• Northwoods Behavioral Health Center, LLC
• Jasee Novak
• Audra A Olson, RPH
• Paul Linderud
• Rebecca D Perry, MD

• General Practice Dentistry in Crandon, WI
• Providers in Crandon, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.