Jason M Mailhot, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

6063-015 Issued in WI

Practice address

2600 N Mayfair Rd
Suite #340
Wauwatosa, WI 53226-1309

Phone

(414) 259-0660

Fax

(414) 259-0819

NPI assigned

May 23, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Barton & Shaw Periodontics

  • Periodontics
  • Wauwatosa, WI
  • NPI 1962522334
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1851346613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4857 WHITE SWAN DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959192",
            "telephone_number": "262-644-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD",
            "address_2": "SUITE #340",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261309",
            "telephone_number": "414-259-0660",
            "fax_number": "414-259-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAILHOT",
        "first_name": "JASON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WI",
            "license": "6063-015",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "DN012270",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZG0219",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra E Mackman, M.P.T.
• Jay L Mackman, DDS
• Basil U Maduka, NP
• James R Magliocco, D.O.
• Magnify LLC
• Taketa Marie Majeed, LPC
• Nicole Maki-Rydland
• Jamie Lynn Malan
• John R Malensek, DDS
• Victoria Kaye Maloney, PA-C

• Periodontics in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Periodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.