Active NPI
Donald Roy Torgerson, DDS
- General Practice Dentistry
- Rice Lake, WI
National Provider Identifier
1144349762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5001430G015
- Practice address
- 207 E South St
Rice Lake, WI 54868-3019 - Phone
- (715) 234-3511
- Fax
- (715) 736-0716
- NPI assigned
- Mar 28, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5001430G015 | WI | Primary |
Addresses
Primary practice location
207 E South St
Rice Lake, WI 54868-3019
Mailing address
207 E South St
Rice Lake, WI 54868-3019
Phone (715) 234-3511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33655000 | Medicaid | WI |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151216001748 | WI | Order and Referring Only - Dentist | 7416258405 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5001430G015 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144349762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 E SOUTH ST",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548683019",
"telephone_number": "715-234-3511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 E SOUTH ST",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548683019",
"telephone_number": "715-234-3511",
"fax_number": "715-736-0716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TORGERSON",
"first_name": "DONALD",
"middle_name": "ROY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "5001430G015",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33655000",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rice Lake, WI
Sources for this page
- 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.