Wendy A. Jativa, D.D.S, M.S

Primary specialty

DentistTaxonomy code 122300000X

License

2901019590 Issued in MI

Practice address

147 West Michigan Ave
Clinton, MI 49236

Phone

(517) 456-7471

Fax

(517) 456-7596

NPI assigned

Aug 5, 2007

Last updated

Apr 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 MI

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

Credentials

Master of Science

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.

• Jativa Family Dental

  • Dental Clinic/Center
  • Clinton, MI
  • NPI 1376124552
  NPD
• Jan M Rizzo DDS PC

  • Dental Clinic/Center
  • Clinton, MI
  • NPI 1720125842
  NPD (past)
• Livingston Dental Sleep Therapy PLLC

  • Dentist
  • Brighton, MI
  • NPI 1629414255
  NPD (past)

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1790976884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 WEST MICHIGAN AVE",
            "city": "CLINTON",
            "state": "MI",
            "postal_code": "49236",
            "telephone_number": "517-456-7471",
            "fax_number": "517-456-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 WEST MICHIGAN AVE",
            "city": "CLINTON",
            "state": "MI",
            "postal_code": "49236",
            "telephone_number": "517-456-7471",
            "fax_number": "517-456-7596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JATIVA",
        "first_name": "WENDY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S, M.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iha Health Services Corporation (IHA Clinton Primary Care)
• Courtney Iwanicki, MS, RD, CSP
• James T. Sheneman, D.C., PLLC
• Jan M Rizzo DDS PC
• Jativa Family Dental
• Dennis Richard Kaechele, D.D.S.,M.S.
• Meghan Kelly, A.T.C.
• Kosmyna Chiropractic Life Center PC
• Thomas Steven Kosmyna, DC
• Adam Kosteva, MD

• Dentist in Clinton, MI
• Providers in Clinton, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.