Jamie L. Mandigo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6242 Issued in WI

Practice address

2574 Sun Valley Dr
Ste 100
Delafield, WI 53018

Phone

(262) 337-9745

Fax

(262) 337-9780

NPI assigned

Jun 16, 2008

Last updated

Feb 26, 2025By the provider in NPPES

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 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

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1730349432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2574 SUN VALLEY DR",
            "address_2": "STE 100",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "53018",
            "telephone_number": "262-337-9745",
            "fax_number": "262-337-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2574 SUN VALLEY DR",
            "address_2": "STE 100",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "53018",
            "telephone_number": "262-337-9745",
            "fax_number": "262-337-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDIGO",
        "first_name": "JAMIE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2025-02-26",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Catherine Lien, LPC
• Heidi Lindsey
• Livefree Health LLC
• Nicole Elizabeth Lotz
• Shelly R Lund, LCSW
• Many Roads Clinic
• Melissa D Marsh, PT
• Darcy Jo McCormick, PTA, CPT
• MD21 Global (AvanceMD)
• Sara Marie Mehring, RN

• Dentist in Delafield, WI
• Providers in Delafield, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.