Individual provider Active NPI

Madison Kasparek, DDS

  • Dentist
  • Wausau, WI
National Provider Identifier
1497480685
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6001037-15 Issued in WI
Practice address
301 N 17TH Ave # 200
Wausau, WI 54401-4225
Phone
(715) 842-3933
NPI assigned
Jul 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X PAR-0000001717 WI
Dentist 122300000X 6001037-15 WI Primary

Addresses

Primary practice location

301 N 17TH Ave # 200
Wausau, WI 54401-4225

Mailing address

301 N 17TH Ave # 200
Wausau, WI 54401-4225
Phone (715) 842-3933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6001037-15WIMDDentist
PAR-0000001717WIMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497480685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N 17TH AVE # 200",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014225",
            "telephone_number": "715-842-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 17TH AVE # 200",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014225",
            "telephone_number": "715-842-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASPAREK",
        "first_name": "MADISON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "PAR-0000001717",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001037-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.