Thomas D Yentz, D.D.S.
Individual provider Active NPI General Practice Dentistry · Spring Green, WI
NPI 1366421091 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1366421091
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 3492-015 (WI)
- Practice address
- 240 W. Jefferson Street
Spring Green, WI 53588 - Phone
- (608) 588-2122
- Fax
- (608) 588-9152
- NPI assigned
- Jan 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150601001125 | WI | Order and Referring Only - Dentist |
0143541318 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3492-015 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Village Family Dental Associates | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3492-015 | WI | Yes |
Addresses
Primary practice location
240 W. Jefferson Street
Spring Green, WI 53588
Mailing address
240 W. Jefferson Street
Spring Green, WI 53588
Phone (608) 588-2122
Other providers in Spring Green, WI
- Upland Hills Health, Inc.
- Village Family Dental Associates
- Jeffrey L Vodak
- Jaclyn M Wilkinson
- Robert John Wright
All providers in Spring Green, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.