Individual provider Active NPI

Robert Melvin Villwock, DDS

  • Dentist
  • Green Bay, WI
National Provider Identifier
1396969192
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2519 Issued in WI
Practice address
1401 Kingston Terrace
Green Bay, WI 54302-5405
Phone
(920) 465-4477
Fax
(920) 465-4479
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2519 WI Primary

Addresses

Primary practice location

1401 Kingston Terrace
Green Bay, WI 54302-5405

Mailing address

1401 Kingston Terrace
Green Bay, WI 54302-5405
Phone (920) 465-4477

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180207002272 WI Practitioner - Dentist 6800107681 Practice locations: Green Bay, WI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nein Schnarchen Inc CurrentSince Oct 29, 2018 Accepting new patients

Locations

1401 Kingston Ter
Green Bay, WI 54302
Phone (920) 465-4477

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396969192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 KINGSTON TERRACE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543025405",
            "telephone_number": "920-465-4477",
            "fax_number": "920-465-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 KINGSTON TERRACE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543025405",
            "telephone_number": "920-465-4477",
            "fax_number": "920-465-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLWOCK",
        "first_name": "ROBERT",
        "middle_name": "MELVIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "2519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.