Individual provider Active NPI

Ralph Stanley Robe, DDS

  • Dentist
  • New Berlin, WI
National Provider Identifier
1104878479
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2636015 Issued in WI
Practice address
13700 W National Ave
Suite 209
New Berlin, WI 53151-9521
Phone
(262) 796-9900
Fax
(262) 796-5102
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2636015 WI Primary

Addresses

Primary practice location

13700 W National Ave
Suite 209
New Berlin, WI 53151-9521

Mailing address

13700 W National Ave
Suite 209
New Berlin, WI 53151-9521
Phone (262) 796-9900

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150521002755 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1759601362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2636015WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1104878479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13700 W NATIONAL AVE",
            "address_2": "SUITE 209",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531519521",
            "telephone_number": "262-796-9900",
            "fax_number": "262-796-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13700 W NATIONAL AVE",
            "address_2": "SUITE 209",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531519521",
            "telephone_number": "262-796-9900",
            "fax_number": "262-796-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBE",
        "first_name": "RALPH",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "2636015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

Verify at the official NPI Registry.