Jeremy Hoffman, DDS
Individual provider Active NPI General Practice Dentistry · Marathon, WI
NPI 1437288891 · NPPES record last updated Mar 12, 2015
Key facts
- NPI
- 1437288891
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5711 (WI)
- Practice address
- 981 Blue Stone LN
Marathon, WI 54448-6800 - Phone
- (715) 443-2200
- NPI assigned
- Mar 3, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150608002217 | WI | Order and Referring Only - Oral Surgery |
9234450818 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5711 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marathon Family Dentistry, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5711 | WI | Yes |
Addresses
Primary practice location
981 Blue Stone LN
Marathon, WI 54448-6800
Mailing address
981 Blue Stone LN
Marathon, WI 54448-6800
Phone (715) 443-2200
Other providers in Marathon, WI
- Nancy Dinjer
- Family Foot and Ankle Clinic LLC
- Amy Fromm
- Dana Gertschen
- Yaser Haleem
- Christine A. Hoyt
- Integrate Functional Health
- Mya Jablonski
- Paul M Lorentson
- Derek Lund
All providers in Marathon, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.