Stacie A Piacsek, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4607 Issued in WI

Practice address

820 Summit Ave
Oconomowoc, WI 53066-3920

Phone

(262) 567-4466

Fax

(262) 567-5957

NPI assigned

Mar 15, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Enrolled in WI

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366576159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 SUMMIT AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663920",
            "telephone_number": "262-567-4466",
            "fax_number": "262-567-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 SUMMIT AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663920",
            "telephone_number": "262-567-4466",
            "fax_number": "262-567-5957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIACSEK",
        "first_name": "STACIE",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Lauren Pflughoeft, APNP
• Phil Slaughter Physical Therapy & Rehabilitation Specialists, LLC
• Philip M Marden MD SC
• Michael J Phillips, M.D.
• Physical Medicine Institute of Wisconsin
• Lona Piber
• Mark S Polentini, MD
• Mischel Pomasl, CSW, CSAC
• Kaley Poole
• Ian R Powell, M.D.

• Dentist in Oconomowoc, WI
• Providers in Oconomowoc, WI by specialty
• Dentist 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.