Active NPI
Edward Robert Dunbar, DDS
- Dentist
- Shell Lake, WI
National Provider Identifier
1437112331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5001675
- Practice address
- 600 East County Highway B
Shell Lake, WI 54871-0356 - Phone
- (715) 468-2125
- Fax
- (715) 468-2167
- NPI assigned
- Apr 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5001675 | WI | Primary |
Addresses
Primary practice location
600 East County Highway B
Shell Lake, WI 54871-0356
Mailing address
PO Box 356
Shell Lake, WI 54871-0356
Phone (715) 468-2125
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33353200 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5001675 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295308800000",
"number": "1437112331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 356",
"city": "SHELL LAKE",
"state": "WI",
"postal_code": "548710356",
"telephone_number": "715-468-2125",
"fax_number": "715-468-2167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 EAST COUNTY HIGHWAY B",
"city": "SHELL LAKE",
"state": "WI",
"postal_code": "548710356",
"telephone_number": "715-468-2125",
"fax_number": "715-468-2167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNBAR",
"first_name": "EDWARD",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-11",
"last_updated": "2011-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "5001675",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33353200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shell Lake, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.