Mary Lenz, DDS
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Union Grove, WI
NPI 1477089415 · NPPES record last updated May 11, 2017
Key facts
- NPI
- 1477089415
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 951 Main St Ste 100
Union Grove, WI 53182-1074 - Phone
- (262) 878-2422
- NPI assigned
- May 11, 2017
- 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 |
|---|---|---|---|---|
| I20171109001957 | WI | Order and Referring Only - Dentist |
6608132527 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
951 Main St Ste 100
Union Grove, WI 53182-1074
Mailing address
1221 N 62ND St Ste 201
Wauwatosa, WI 53213-3077
Phone (262) 758-0706
Other names
- Mary Kastengren
Other providers in Union Grove, WI
- Sarah Koldeway
- Elizabeth P Kravig
- Lane Thomas Laclair
- Mary Lakomy
- Kristin Marie Lenz Galbreath
- Geraldine Ilene Linden
- Anthony R Matoska
- Serena Jeane Matteson
- Melby Chiropractic Clinic, S.C.
- William I Melby
All providers in Union Grove, WI · Student in an Organized Health Care Education/Training Program in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2017. 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.