Individual provider Active NPI

DJ Foster, DDS

  • Dentist
  • Lac Du Flambeau, WI
National Provider Identifier
1245788330
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6875 Issued in OK
Practice address
128 Old Abe Rd
Lac Du Flambeau, WI 54538-9386
Phone
(715) 588-4269
Fax
(715) 588-2269
NPI assigned
Sep 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6875 OK Primary

Addresses

Primary practice location

128 Old Abe Rd
Lac Du Flambeau, WI 54538-9386

Mailing address

128 Old Abe Rd
Lac Du Flambeau, WI 54538-9386
Phone (715) 588-4269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20191101001166 OK Practitioner - Dentist 5395025316 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6875OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Oct 21, 2019 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Oct 21, 2019 Accepting new patients
Lac Du Flambeau Band of Lake Superior Chippewa Indians Past Accepting new patients

Locations

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310

Dept 1467
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: dfoster728068@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1474070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1245788330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 OLD ABE RD",
            "city": "LAC DU FLAMBEAU",
            "state": "WI",
            "postal_code": "545389386",
            "telephone_number": "715-588-4269",
            "fax_number": "715-588-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 OLD ABE RD",
            "city": "LAC DU FLAMBEAU",
            "state": "WI",
            "postal_code": "545389386",
            "telephone_number": "715-588-4269",
            "fax_number": "715-588-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "DJ",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-17",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lac Du Flambeau, WI

Sources for this page

Verify at the official NPI Registry.