Craig James Forsberg, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2948 Issued in WI

Practice address

210 N Leonard St
West Salem, WI 54669-1623

Phone

(608) 786-1632

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Dentistry of West Salem, Inc.

  • General Practice Dentistry
  • West Salem, WI
  • NPI 1821131210
  NPD (past) Authorized official General Practice

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2007.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1467529669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N LEONARD ST",
            "city": "WEST SALEM",
            "state": "WI",
            "postal_code": "546691623",
            "telephone_number": "608-786-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N LEONARD ST",
            "city": "WEST SALEM",
            "state": "WI",
            "postal_code": "546691623",
            "telephone_number": "608-786-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSBERG",
        "first_name": "CRAIG",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "2948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33441300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• County of la Crosse
• County of la Crosse
• Jennifer Nicole Craugh, MT-BC
• Family Dentistry of West Salem, Inc.
• Sara Flaig, PTA
• Hannah Jo Gaethke, BSN RN
• Kaitlin Gelbmann, LMT
• Kathryn A Gerstenberger, OTR
• Erin Gleason, MT-BC, WMTR
• Ashley Gravelle, DC

• All providers in West Salem, WI
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.