Charles Polzin, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6605-15 Issued in WI

Practice address

2268 N Shore Dr
Rhinelander, WI 54501-8888

Phone

(715) 420-1400

Fax

(715) 420-0701

NPI assigned

Apr 20, 2010

Last updated

Jan 7, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Oral Surgery

Education

Marquette University School of Dentistry, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Health System-Franciscan Medical Center Inc Hospital, La Crosse, WI, CCN 520004

Medicare enrollment (NPD)

Enrolled

State licenses

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Franciscan Healthcare - La Crosse

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1801874227
  Care Compare affiliation

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1144546805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2268 N SHORE DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545018888",
            "telephone_number": "715-420-1400",
            "fax_number": "715-420-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2268 N SHORE DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545018888",
            "telephone_number": "715-420-1400",
            "fax_number": "715-420-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLZIN",
        "first_name": "CHARLES",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-20",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "6605-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ann Pittman, ED.D.
• Bridget Plautz
• Jennifer Podeweltz, SAC-IT
• Podiatry Associates of Wausau, S.C.
• Dean M Pollnow, MD
• Kayla Michelle Poncek
• Theresa Jean Price-Decker, MS, LCSW
• Priority Medical Partners, SC
• Heidi Lynn Raddatz, M.S. CCC-SLP
• Jacob P Ramsby, PT, DPT, CSCS

• Oral and Maxillofacial Surgery (Dentist) in Rhinelander, WI
• Providers in Rhinelander, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.