Individual provider Active NPI

Louis H. Heitke, DDS

  • Dentist
  • Madison, WI
National Provider Identifier
1073778668
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2469 Issued in WI
Practice address
122 E Johnson St
Madison, WI 53703-2120
Phone
(608) 257-0116
Fax
(608) 257-8901
NPI assigned
Jul 23, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2469 WI Primary

Addresses

Primary practice location

122 E Johnson St
Madison, WI 53703-2120

Mailing address

122 E Johnson St
Madison, WI 53703-2120
Phone (608) 257-0116

Other identifiers 1

IdentifierTypeStateIssuer
33406200MedicaidWI

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

LicenseStateTypeSpecialty
2469WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Isthmus Family Dental LLC Past Accepting new patients
Isthmus Dental, LTD Dentist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1073778668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E JOHNSON ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032120",
            "telephone_number": "608-257-0116",
            "fax_number": "608-257-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E JOHNSON ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032120",
            "telephone_number": "608-257-0116",
            "fax_number": "608-257-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITKE",
        "first_name": "LOUIS",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-23",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "2469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33406200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.