Jared Sexauer, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4840 Issued in ID

Practice address

455 N 3Rd E
Mountain Home, ID 83647-2738

Phone

(208) 587-2625

NPI assigned

Jun 5, 2017

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Mountain Home Dental PC

  • Dental Clinic/Center
  • Mountain Home, ID
  • NPI 1801437447
  NPD Authorized official

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1952830945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 N 4TH E",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 N 3RD E",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472738",
            "telephone_number": "208-587-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEXAUER",
        "first_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sequel Tsi of Idaho
• Sequel Tsi of Idaho, LLC
• Sequel Tsi of Idaho, LLC
• Sequel Tsi of Idaho, LLC
• Scott W Sessions, P.T.
• Shalom Prenatal & Birthing Services LLC
• Linda G Shaw, FNP
• Katherine Elizabeth Sheffield, RN
• Colten Young Sicard
• Jenny Rochelle Simison

• General Practice Dentistry in Mountain Home, ID
• Providers in Mountain Home, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.