Individual provider Active NPI

Leroy Joseph Behrens, DDS

  • Dentist
  • Stevens Point, WI
National Provider Identifier
1144323171
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5001897 Issued in WI
Practice address
2201 Division St
Suite B
Stevens Point, WI 54481-3662
Phone
(715) 341-1644
NPI assigned
Sep 6, 2006
Last updated
Dec 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5001897 WI Primary

Addresses

Primary practice location

2201 Division St
Suite B
Stevens Point, WI 54481-3662

Mailing address

2201 Division St
Suite B
Stevens Point, WI 54481-3662
Phone (715) 341-1644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20160419000237 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3870891237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5001897WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1144323171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 DIVISION ST",
            "address_2": "SUITE B",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544813662",
            "telephone_number": "715-341-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 DIVISION ST",
            "address_2": "SUITE B",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544813662",
            "telephone_number": "715-341-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHRENS",
        "first_name": "LEROY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5001897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

Sources for this page

Verify at the official NPI Registry.