Active NPI
Bruce Lee Pomerening, DDS
- Dentist
- Prairie Du Chien, WI
National Provider Identifier
1437239209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- WI53134
- Practice address
- 109 South Beaumont Rd
Prairie Du Chien, WI 53821 - Phone
- (608) 326-2332
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 | WI53134 | WI | Primary |
Addresses
Primary practice location
109 South Beaumont Rd
Prairie Du Chien, WI 53821
Mailing address
109 South Beaumont Rd
Prairie Du Chien, WI 53821
Phone (608) 326-2332
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 |
|---|---|---|---|
| WI53134 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437239209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 SOUTH BEAUMONT RD",
"city": "PRAIRIE DU CHIEN",
"state": "WI",
"postal_code": "53821",
"telephone_number": "608-326-2332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 SOUTH BEAUMONT RD",
"city": "PRAIRIE DU CHIEN",
"state": "WI",
"postal_code": "53821",
"telephone_number": "608-326-2332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POMERENING",
"first_name": "BRUCE",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "WI53134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prairie Du Chien, WI
Sources for this page
- 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.