Reena Abraham, DMD
Individual provider Active NPI General Practice Dentistry · Marshfield, WI
NPI 1457589491 · NPPES record last updated Aug 8, 2011
Key facts
- NPI
- 1457589491
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6580 (WI)
- Practice address
- 2416 N Peach Ave
Apt 3
Marshfield, WI 54449-8355 - Phone
- (715) 254-1094
- NPI assigned
- Jun 29, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| I20191001000975 | WI | Order and Referring Only - Dentist |
8921338146 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS037906 | PA | MD | Dentist |
| 6580 | WI | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS037906 | PA | |
| General Practice Dentistry | 1223G0001X | 6580 | WI | Yes |
Addresses
Primary practice location
2416 N Peach Ave
Apt 3
Marshfield, WI 54449-8355
Mailing address
2416 N Peach Ave
Apt 3
Marshfield, WI 54449-8355
Other names
- Reena Mathews
Other providers in Marshfield, WI
- Ihab B Abdalrahman
- Raquel Abengozar Mingorance
- Aanuoluwa Abiola
- C Timothy Ablett
- Petra Abou Lhosn
- Absolute Health Chiropractic SC
- Asem Abu-Jamea
- Karalyn M Adam
- Travis L. Adams
- Abdirahim Abdi Aden
All providers in Marshfield, 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 Aug 8, 2011. 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.