Dr. Jared P Isom , DDS
Dentist - General Practice • Millstadt, IL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jared Isom has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Jared Isom, DDS was a registered Dentist - General Practice practicing in Millstadt, IL. Throughout an active medical career spanning 12 years, Dr. Isom provided care at the practice location at 200 W MILL ST until profile deactivation on 2018-12-10.
Practice Location & Contact Primary Location
200 W Mill St
Millstadt, IL 622601148
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Millstadt, IL
Practicing in Millstadt, IL (5581 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 1223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on December 10, 2018
NPI status registered as active in NPPES database
Registered at 200 W MILL ST, MILLSTADT, IL 622601148 (Tel: 6184761400)
Registered at 200 W MILL ST, MILLSTADT, IL 622601148 (Tel: 6184761400)
Recorded as JARED ISOM, D.D.S.
Dentist
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
200 W Mill St
Millstadt, IL 622601148
Phone: 6184761400
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