Individual provider Active NPI

Jared J Schellenberg, DDS

  • Endodontics
  • Columbus, OH
National Provider Identifier
1770846537
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
RES3198 Issued in OH
Practice address
305 W 12TH Ave
Columbus, OH 43210-1267
Phone
(614) 292-6160
NPI assigned
Jun 18, 2012
Last updated
Jun 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X RES3198 OH Primary

Addresses

Primary practice location

305 W 12TH Ave
Columbus, OH 43210-1267

Mailing address

4489 Westborough Dr W
Columbus, OH 43220-3718
Phone (801) 592-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20160201001601 OK Order and Referring Only - DentistPractitioner - Dentist 3870897507

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RES3198OHMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1770846537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4489 WESTBOROUGH DR W",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432203718",
            "telephone_number": "801-592-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W 12TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-292-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHELLENBERG",
        "first_name": "JARED",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "RES3198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.