Individual provider Active NPI

Joel Mark Hartjes, DDS

  • General Practice Dentistry
  • Middleton, WI
National Provider Identifier
1972677920
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4461 Issued in WI
Practice address
1001 N Gammon Rd
Suite 2
Middleton, WI 53562-3874
Phone
(608) 836-5600
Fax
(608) 836-4589
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4461 WI Primary

Addresses

Primary practice location

1001 N Gammon Rd
Suite 2
Middleton, WI 53562-3874

Mailing address

1001 N Gammon Rd
Suite 2
Middleton, WI 53562-3874
Phone (608) 836-5600

Other identifiers 1

IdentifierTypeStateIssuer
33784500MedicaidWI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160510000103 WI Order and Referring Only - DentistPractitioner - Dentist 5294024584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hartjes Dental Association, LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1972677920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N GAMMON RD",
            "address_2": "SUITE 2",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623874",
            "telephone_number": "608-836-5600",
            "fax_number": "608-836-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N GAMMON RD",
            "address_2": "SUITE 2",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623874",
            "telephone_number": "608-836-5600",
            "fax_number": "608-836-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTJES",
        "first_name": "JOEL",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33784500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

Verify at the official NPI Registry.