Active NPI
Richard Holubowicz
- General Practice Dentistry
- Brookfield, WI
National Provider Identifier
1306902713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3351
- Practice address
- 1025 S Moorland Rd
Suite 201
Brookfield, WI 53005-6956 - Phone
- (262) 782-5454
- Fax
- (262) 782-1630
- NPI assigned
- Dec 29, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | 3351 | WI | Primary |
Addresses
Primary practice location
1025 S Moorland Rd
Suite 201
Brookfield, WI 53005-6956
Mailing address
1025 S Moorland Rd
Suite 201
Brookfield, WI 53005-6956
Phone (262) 782-5454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3351 | WI | MD | Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306902713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 S MOORLAND RD",
"address_2": "SUITE 201",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530056956",
"telephone_number": "262-782-5454",
"fax_number": "262-782-1630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 S MOORLAND RD",
"address_2": "SUITE 201",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530056956",
"telephone_number": "262-782-5454",
"fax_number": "262-782-1630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLUBOWICZ",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "3351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.