Roger L Zimmerman, D.D.S.

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

5000111 Issued in WI

Practice address

464 S Hickory St
Fond Du Lac, WI 54935-5531

Phone

(920) 923-0111

Fax

(920) 923-0366

NPI assigned

Sep 22, 2006

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.

• Oral Surgery Assoc LTD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Fond Du Lac, WI
  • NPI 1013020866
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043319056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 S HICKORY ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549355531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 S HICKORY ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549355531",
            "telephone_number": "920-923-0111",
            "fax_number": "920-923-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "ROGER",
        "middle_name": "L",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "WI",
            "license": "5000111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara J Zeman, CAA
• Sandra K Zernzach-Schertz, NP
• Michelle A Ziegelbauer, FNP-BC
• Sara Ann Ziegler, APNP
• Brittany Zimmer, OTR/L
• Jeremy J Zimmermann, DO
• Barbara D Zink, MD
• Zipmile Services
• Kent Alan Zocher, DDS
• Michael K Zoelle, OD

• Oral and Maxillofacial Pathology Dentistry in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Oral and Maxillofacial Pathology Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.