Individual provider Active NPI

William D Bethke, DDS

  • General Practice Dentistry
  • Eau Claire, WI
National Provider Identifier
1154446508
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3548015 Issued in WI
Practice address
3131 Stein Blvd
Eau Claire, WI 54701-6997
Phone
(715) 835-7172
Fax
(715) 835-5841
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3548015 WI Primary

Addresses

Primary practice location

3131 Stein Blvd
Eau Claire, WI 54701-6997

Mailing address

3131 Stein Blvd
Eau Claire, WI 54701-6997
Phone (715) 835-7172

Other identifiers 1

IdentifierTypeStateIssuer
33483500OtherWIWI MA

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
3548015WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154446508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016997",
            "telephone_number": "715-835-7172",
            "fax_number": "715-835-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016997",
            "telephone_number": "715-835-7172",
            "fax_number": "715-835-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHKE",
        "first_name": "WILLIAM",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3548015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI MA",
            "identifier": "33483500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.