Eileen K Panacek, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2760 Issued in WI

Practice address

1900 Lathrop Ave
Racine, WI 53405

Phone

(262) 632-0719

Fax

(262) 632-1007

NPI assigned

Jul 26, 2006

Last updated

Apr 12, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 25, 2016 through Jul 25, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1336162767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 LATHROP AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "53405",
            "telephone_number": "262-632-0719",
            "fax_number": "262-632-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 LATHROP AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "53405",
            "telephone_number": "262-632-0719",
            "fax_number": "262-632-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANACEK",
        "first_name": "EILEEN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "2760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen J. Pagano, M.D.
• Elmo G Painter-Edington, LPC
• Nickey Lee Paison
• Debra Sue Palmer, DDS
• Richard E Palmer, DDS
• Mary Panyk Oshiro, D.D.S.
• Michael L. Papp, D.O.
• Camille A. Paquette-Schulgit, M.D.
• Irene Louise Parent, D.C.
• Anthony J Park, MD

• General Practice Dentistry in Racine, WI
• Providers in Racine, 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 Apr 12, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.