Individual provider Active NPI

David M Teske, DDS

  • General Practice Dentistry
  • Green Bay, WI
National Provider Identifier
1295815066
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5000841015 Issued in WI
Practice address
700 E Walnut St
Green Bay, WI 54301-4052
Phone
(920) 435-9400
Fax
(920) 964-1090
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5000841015 WI Primary

Addresses

Primary practice location

700 E Walnut St
Green Bay, WI 54301-4052

Mailing address

700 E Walnut St
Green Bay, WI 54301-4052
Phone (920) 435-9400

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
5000841015WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
N.E.W. Community Clinic, LTD 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.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295815066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E WALNUT ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014052",
            "telephone_number": "920-435-9400",
            "fax_number": "920-964-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E WALNUT ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014052",
            "telephone_number": "920-435-9400",
            "fax_number": "920-964-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESKE",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5000841015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.