Active NPI
Randal Lee Valenta, DDS
- General Practice Dentistry
- Marinette, WI
National Provider Identifier
1215059845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5537
- Practice address
- 1838 Dunlap Ave
Marinette, WI 54143-1722 - Phone
- (715) 735-5626
- Fax
- (715) 735-3283
- NPI assigned
- Apr 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 5537 | WI | Primary |
Addresses
Primary practice location
1838 Dunlap Ave
Marinette, WI 54143-1722
Mailing address
PO Box 480
1838 Dunlap Ave
Marinette, WI 54143-0480
Phone (715) 735-5626
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5537 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johnson & Valenta Family Dentistry SC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Marinette, WI
- NPI 1861728339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257120000000",
"number": "1215059845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 480",
"address_2": "1838 DUNLAP AVE",
"city": "MARINETTE",
"state": "WI",
"postal_code": "541430480",
"telephone_number": "715-735-5626",
"fax_number": "715-735-3283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1838 DUNLAP AVE",
"city": "MARINETTE",
"state": "WI",
"postal_code": "541431722",
"telephone_number": "715-735-5626",
"fax_number": "715-735-3283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENTA",
"first_name": "RANDAL",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-04",
"last_updated": "2009-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "5537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marinette, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.