Individual provider Active NPI

Thomas Henry Luepke III, D.D.S.

  • General Practice Dentistry
  • Eau Claire, WI
National Provider Identifier
1508001694
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5025-015 Issued in WI
Practice address
1102 Regis CT
Eau Claire, WI 54701-4404
Phone
(715) 835-3334
Fax
(715) 552-1552
NPI assigned
Dec 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5025-015 WI Primary

Addresses

Primary practice location

1102 Regis CT
Eau Claire, WI 54701-4404

Mailing address

1102 Regis CT
Eau Claire, WI 54701-4404
Phone (715) 835-3334

Medicare participation

Medicare enrollment files
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160902000957 WI Order and Referring Only - DentistPractitioner - Dentist 2567758360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5025-015WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Regis Court Family Dental S.C. General Practice PastSince Sep 29, 2019 Accepting new patients
Lisa Henson DMD LLC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1508001694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 REGIS CT",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014404",
            "telephone_number": "715-835-3334",
            "fax_number": "715-552-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 REGIS CT",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014404",
            "telephone_number": "715-835-3334",
            "fax_number": "715-552-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEPKE",
        "first_name": "THOMAS",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5025-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.