Puja J Bhakta, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

1001499 Issued in WI

Practice address

430 Main St
Green Bay, WI 54301-5115

Phone

(920) 431-0345

NPI assigned

Mar 2, 2015

Sex

Female

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baycare Clinic LLP

  • Emergency Medicine Physician
  • Green Bay, WI
  • NPI 1588609648

  Oral & Maxillofacial Surgery

  Medicare reassignment NPD
• Baycare Clinic LLP

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1134490758

  Oral & Maxillofacial Surgery

  NPD
• Dental Associates LTD of Wisconsin

  • Endodontics
  • Wauwatosa, WI
  • NPI 1518266998
  NPD
• New Oral & Facial Surgery, SC

  • Oral and Maxillofacial Surgery (Dentist)
  • Green Bay, WI
  • NPI 1609634351
  NPD (past)
• Unm Medical Group Inc

  • Developmental Disabilities Clinic/Center
  • Albuquerque, NM
  • NPI 1851614432
  NPD (past)

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1184016933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11711 W BURLEIGH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532223196",
            "telephone_number": "414-771-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MAIN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543015115",
            "telephone_number": "920-431-0345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2581 Development Dr",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "54311",
            "country_code": "US",
            "telephone_number": "920-347-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHAKTA",
        "first_name": "PUJA",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "WI",
            "license": "1001499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry Sue Betts, PTA
• Heather Jean Bevers, DNP, APNP, FNP-C
• James R Beversdorf, LAT, CSCS, PES
• Richard Lawrence Beyer, BC HIS
• Jennifer Rae Beyette
• Ashwani Bhatia, MD
• Pranav Bhide
• Geeta Bhojwani, OTR
• Chitra Sadasiwan Bhosekar, M.D
• Christian Robert Bialk, PHARMD

• Oral & Maxillofacial Surgery (D.M.D.) in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.

Verify at the official NPI Registry.