Active NPI
Sara Megan Trent, D.D.S.
- General Practice Dentistry
- Oshkosh, WI
National Provider Identifier
1255460614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6016015
- Practice address
- 1050 S Koeller St
Oshkosh, WI 54902-6172 - Phone
- (920) 235-3023
- Fax
- (920) 235-4318
- NPI assigned
- Mar 3, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 6016015 | WI | Primary |
Addresses
Primary practice location
1050 S Koeller St
Oshkosh, WI 54902-6172
Mailing address
454 Edgewood Dr
Neenah, WI 54956-4619
Phone (920) 486-1451
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160503000493 | WI | Order and Referring Only - Other (Non-Physician) | 7416256052 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6016015 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231113600000",
"number": "1255460614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "454 EDGEWOOD DR",
"city": "NEENAH",
"state": "WI",
"postal_code": "549564619",
"telephone_number": "920-486-1451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 S KOELLER ST",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549026172",
"telephone_number": "920-235-3023",
"fax_number": "920-235-4318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRENT",
"first_name": "SARA",
"middle_name": "MEGAN",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-03",
"last_updated": "2009-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "6016015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oshkosh, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; 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.