Individual provider Active NPI

Charles E. Crisler, D.D.S.

  • General Practice Dentistry
  • Rice Lake, WI
National Provider Identifier
1417949660
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4527-WI Issued in WI
Practice address
1507 W Knapp St
Rice Lake, WI 54868-1383
Phone
(715) 234-6846
Fax
(715) 234-0014
NPI assigned
Aug 15, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4527-WI WI Primary

Addresses

Primary practice location

1507 W Knapp St
Rice Lake, WI 54868-1383

Mailing address

1507 W Knapp St
Rice Lake, WI 54868-1383
Phone (715) 234-6846

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
I20151228001904 WI Order and Referring Only - DentistPractitioner - Dentist 8426359936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4527-WIWIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Toboggan Run Dental Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417949660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 W KNAPP ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681383",
            "telephone_number": "715-234-6846",
            "fax_number": "715-234-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 W KNAPP ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681383",
            "telephone_number": "715-234-6846",
            "fax_number": "715-234-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISLER",
        "first_name": "CHARLES",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4527-WI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

Verify at the official NPI Registry.