Kenneth Martin Hartenian, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5001323 Issued in WI

Practice address

33 E Waldo Blvd
Manitowoc, WI 54220

Phone

(920) 684-3353

Fax

(920) 684-8786

NPI assigned

Oct 6, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396832028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 E WALDO BLVD",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "54220",
            "telephone_number": "920-684-3353",
            "fax_number": "920-684-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 E WALDO BLVD",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "54220",
            "telephone_number": "920-684-3353",
            "fax_number": "920-684-8786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTENIAN",
        "first_name": "KENNETH",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "5001323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70032900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Alan Hansen, M.D.
• Judith Hanson
• Peter Michael Hanson, DDS
• Beverly Faye Hardiman
• Harmony Personal Home Care, LLC
• Amanda Hartwig, LPC
• Angela Hastreiter, D.C.
• Kaylee Lynn Hawks, FNP-C
• Edith Ann Headrick, R.N.
• Margaret M Heffernan, PHD

• Oral and Maxillofacial Surgery (Dentist) in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• Oral and Maxillofacial Surgery (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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.