Craig B Thiessen, D.D.S., M.S.D.

Primary specialty

DentistTaxonomy code 122300000X

License

5856 Issued in WI

Practice address

311 Financial Way
Suite 240
Wausau, WI 54401-4288

Phone

(715) 298-9271

Fax

(715) 298-9272

NPI assigned

Mar 9, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1043341993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 FINANCIAL WAY",
            "address_2": "SUITE 240",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014288",
            "telephone_number": "715-298-9271",
            "fax_number": "715-298-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 FINANCIAL WAY",
            "address_2": "SUITE 240",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014288",
            "telephone_number": "715-298-9271",
            "fax_number": "715-298-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIESSEN",
        "first_name": "CRAIG",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Wausau, WI
• Providers in Wausau, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.