Jacob Austin Wolf, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14744 Issued in MN

Practice address

114 3Rd St N
Cannon Falls, MN 55009-2011

Phone

(507) 263-4501

NPI assigned

May 31, 2022

Last updated

Mar 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

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

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Compass Dental PA

  • Dental Clinic/Center
  • Cannon Falls, MN
  • NPI 1932644648
  NPD

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1760121586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5075 161ST ST W APT 1127",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550445525",
            "telephone_number": "701-540-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 3RD ST N",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550092011",
            "telephone_number": "507-263-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "JACOB",
        "middle_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2456",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Western
• Rachel Laurel Wetzsteon
• Jeffery S Wheeler, MD
• Brian Lee Whited, MD
• Chad Duane Williams, PA-C
• Roberta Bea Wollan
• Mary Katherine Yarbrough, B.A., C.M.T.
• Dannielle Mariette Zielkie, APRN, CNP

• General Practice Dentistry in Cannon Falls, MN
• Providers in Cannon Falls, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.