Charles Anthony Puntillo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5001381 Issued in WI

Practice address

190 Gardner Ave Ste 6
Burlington, WI 53105-2160

Phone

(262) 763-8360

Fax

(262) 763-5868

NPI assigned

Oct 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Burlington Dental Arts LLC

  dba Burlington Dental Arts

  • General Practice Dentistry
  • Burlington, WI
  • NPI 1164089751
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306920442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 GARDNER AVE STE 6",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531052160",
            "telephone_number": "262-763-8360",
            "fax_number": "262-763-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 GARDNER AVE STE 6",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531052160",
            "telephone_number": "262-763-8360",
            "fax_number": "262-763-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNTILLO",
        "first_name": "CHARLES",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Frances Prelog, MSW
• Timothy M Pritzl, OD
• Private Healthcare Facilities
• Professional Psychological Services, SC
• Donna Jeanne Przybylinski, M.A.
• Purath Headache & Neurology, S.C.
• Traci A. Purath, M.D.
• Ramakrishna P Venugopalan MD SC
• Lynn S Raml, OTR
• Randall Joint #1 School District

• General Practice Dentistry in Burlington, WI
• Providers in Burlington, WI by specialty
• General Practice Dentistry in Wisconsin

• 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.