Individual provider Active NPI

Frank A Caputo, D.D.S.

  • General Practice Dentistry
  • Cudahy, WI
National Provider Identifier
1164717732
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6703-015 Issued in WI
Practice address
6217 S Packard Ave
Cudahy, WI 53110-3089
Phone
(414) 764-5550
Fax
(414) 764-9198
NPI assigned
Jun 12, 2011
Last updated
Aug 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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 6703-015 WI Primary

Addresses

Primary practice location

6217 S Packard Ave
Cudahy, WI 53110-3089

Mailing address

1422 24TH St
Apt 10
Kenosha, WI 53140-1811
Phone (262) 960-1934

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
I20160209001729 WI Order and Referring Only - DentistPractitioner - Dentist 6305140518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6703-015WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1307836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1164717732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 24TH ST",
            "address_2": "APT 10",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531401811",
            "telephone_number": "262-960-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6217 S PACKARD AVE",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531103089",
            "telephone_number": "414-764-5550",
            "fax_number": "414-764-9198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPUTO",
        "first_name": "FRANK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-12",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6703-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cudahy, WI

Sources for this page

Verify at the official NPI Registry.