Edward Mark Pflum, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

3593015 Issued in WI

Practice address

342 W Wisconsin Ave
Appleton, WI 54911-4340

Phone

(920) 733-8309

NPI assigned

Mar 1, 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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063540870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 W WISCONSIN AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549114340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 W WISCONSIN AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549114340",
            "telephone_number": "920-733-8309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFLUM",
        "first_name": "EDWARD",
        "middle_name": "MARK",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "3593015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie J Petrie-Kampa, OTR, CHT
• Mikayla Ruth Petzke, NP
• Michelle A Pevonka-Thompson, BSN, RN
• Andrew Pfaffenbach, M.D.
• Elina Xanos Pfaffenbach, M.D.
• Jacob T Pflum, CRNA
• Shannon I Pham, NP
• Philip K. Hornseth, D.D.S., S.C.
• Joyce Rachel Philip, M.D.
• Judith L Phillips, RN

• Dentist in Appleton, WI
• Providers in Appleton, WI by specialty
• Dentist 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.
• 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.