Active NPI
Denise Marie Wentz, MASSAGE THERAPIST
- Massage Therapist
- Mandan, ND
National Provider Identifier
1043516255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 457
- Practice address
- 509 Burlington St SE
Mandan, ND 58554-4272 - Phone
- (701) 224-1561
- Fax
- (701) 223-2319
- NPI assigned
- Feb 4, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 457 | ND | Primary |
Addresses
Primary practice location
509 Burlington St SE
Mandan, ND 58554-4272
Mailing address
509 Burlington St SE
Mandan, ND 58554-4272
Phone (701) 224-1561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 457 | ND | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296777600000",
"number": "1043516255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 BURLINGTON ST SE",
"city": "MANDAN",
"state": "ND",
"postal_code": "585544272",
"telephone_number": "701-224-1561",
"fax_number": "701-223-2319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 BURLINGTON ST SE",
"city": "MANDAN",
"state": "ND",
"postal_code": "585544272",
"telephone_number": "701-224-1561",
"fax_number": "701-223-2319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENTZ",
"first_name": "DENISE",
"middle_name": "MARIE",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-04",
"last_updated": "2011-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ND",
"license": "457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mandan, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.