Active NPI
Jessica H Jarboe, D.D.S.
- General Practice Dentistry
- Fort Wayne, IN
National Provider Identifier
1861695967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12010994A
- Practice address
- 10010 Dupont Circle CT
Fort Wayne, IN 46825-1626 - Phone
- (260) 490-9949
- NPI assigned
- Jun 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12010994A | IN | Primary |
Addresses
Primary practice location
10010 Dupont Circle CT
Fort Wayne, IN 46825-1626
Mailing address
1017 Fiona Dr
Fort Wayne, IN 46845-8847
Phone (260) 348-5265
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12010994A | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R M & M R Stetzel DDS Inc | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Fort Wayne, IN
- NPI 1356463327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861695967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1017 FIONA DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468458847",
"telephone_number": "260-348-5265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10010 DUPONT CIRCLE CT",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468251626",
"telephone_number": "260-490-9949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARBOE",
"first_name": "JESSICA",
"middle_name": "H",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12010994A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.