Individual provider Active NPI

Sara Megan Trent, D.D.S.

  • General Practice Dentistry
  • Oshkosh, WI
National Provider Identifier
1255460614
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6016015 Issued in WI
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

Updated by the provider on Jan 5, 2009

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160503000493 WI Order and Referring Only - Other (Non-Physician) 7416256052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6016015WIMDGeneral 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

Verify at the official NPI Registry.