Joshua Behnke, D.D.S.
Individual provider Active NPI Dentist · Plover, WI
NPI 1013396803 · NPPES record last updated Jul 6, 2016
Key facts
- NPI
- 1013396803
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 1001230-15 (WI)
- Practice address
- 2950 Bea Jay LN
Plover, WI 54467-2716 - Phone
- (715) 341-5220
- NPI assigned
- May 26, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170125000163 | WI | Order and Referring Only - Oral Surgery |
9638451784 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1001230-15 | WI | Yes |
Addresses
Primary practice location
2950 Bea Jay LN
Plover, WI 54467-2716
Mailing address
2950 Bea Jay LN
Plover, WI 54467-2716
Phone (715) 341-5220
Other providers in Plover, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.