Individual provider Active NPI

Joseph Michael Labella, DDS

  • General Practice Dentistry
  • Portage, WI
National Provider Identifier
1265690044
Registry record updated May 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3744 Issued in WI
Practice address
1508 New Pinery Rd
Portage, WI 53901-1312
Phone
(608) 742-4533
Fax
(608) 742-2202
NPI assigned
May 28, 2008
Last updated
May 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2008

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 3744 WI Primary

Addresses

Primary practice location

1508 New Pinery Rd
Portage, WI 53901-1312

Mailing address

1508 New Pinery Rd
Portage, WI 53901-1312
Phone (608) 742-4533

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

LicenseStateTypeSpecialty
3744WIMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1265690044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539011312",
            "telephone_number": "608-742-4533",
            "fax_number": "608-742-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539011312",
            "telephone_number": "608-742-4533",
            "fax_number": "608-742-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABELLA",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.