Provider Demographics
NPI:1013923911
Name:MARCHI, JAIME K (DDS)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:K
Last Name:MARCHI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1313 N TAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-3041
Mailing Address - Country:US
Mailing Address - Phone:920-452-7336
Mailing Address - Fax:920-453-9770
Practice Address - Street 1:1313 N TAYLOR DR
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3041
Practice Address - Country:US
Practice Address - Phone:920-452-7336
Practice Address - Fax:920-453-9770
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI52360151223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33762400Medicaid