Chad M Isken, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6131-015 Issued in WI

Practice address

1414 N Taylor Dr
Sheboygan, WI 53081-1988

Phone

(920) 453-5972

NPI assigned

Jun 17, 2008

Last updated

Mar 27, 2012By the provider in NPPES

Sex

Male

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 WI

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

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1912167529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 N TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811988",
            "telephone_number": "920-453-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 N TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811988",
            "telephone_number": "920-453-5972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISKEN",
        "first_name": "CHAD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6131-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David Michael Jacobi, PH.D.
• Taylor J Jacobs, PT
• Emily Jacobson, DPT
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• General Practice Dentistry in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.