Peter James Nebel, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1002426 Issued in WI

Practice address

128 Old Abe Rd
Lac Du Flambeau, WI 54538-9386

Phone

(715) 588-4269

NPI assigned

Sep 14, 2020

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

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.

• Lac Du Flambeau Band of Lake Superior Chippewa Indians

  • Dental Clinic/Center
  • Lac Du Flambeau, WI
  • NPI 1427347426
  NPD (past)

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1003421272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9790 OLD HIGHWAY 70",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545488722",
            "telephone_number": "920-207-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 OLD ABE RD",
            "city": "LAC DU FLAMBEAU",
            "state": "WI",
            "postal_code": "545389386",
            "telephone_number": "715-588-4269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEBEL",
        "first_name": "PETER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1002426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pauline Ann Martin, RN
• Deanna L Maulson-Greske, SAC-IT
• John David McCrea, DPM
• Colleen M McGuire, RDH
• Mark S Miller, PHARMD.
• Debra L Neddo, CADCIII
• Kenneth R Ninham, MSE
• Amber A. Paczkowski, SAC-IT
• Lauren Peabody McFarlane, DMD
• Robert R Polfus, MA

• Dentist in Lac Du Flambeau, WI
• Providers in Lac Du Flambeau, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.