Active NPI
Lynn Marie Bielmeier Momsen, DDS
- General Practice Dentistry
- Wild Rose, WI
National Provider Identifier
1447358296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4843075
- Practice address
- 474 Summit St
Wild Rose, WI 54984 - Phone
- (920) 622-3118
- Fax
- (920) 622-3138
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4843075 | WI | Primary |
Addresses
Primary practice location
474 Summit St
Wild Rose, WI 54984
Mailing address
PO Box 199
Wild Rose, WI 54984-0199
Phone (920) 622-3118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150326001832 | WI | Order and Referring Only - Oral Surgery | 5092793794 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4843075 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428883200000",
"number": "1447358296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 199",
"city": "WILD ROSE",
"state": "WI",
"postal_code": "549840199",
"telephone_number": "920-622-3118",
"fax_number": "920-622-3138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "474 SUMMIT ST",
"city": "WILD ROSE",
"state": "WI",
"postal_code": "54984",
"telephone_number": "920-622-3118",
"fax_number": "920-622-3138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOMSEN",
"first_name": "LYNN MARIE",
"middle_name": "BIELMEIER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2015-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "4843075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wild Rose, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.