Individual provider Active NPI

Robert Heil, DDS

  • General Practice Dentistry
  • Oshkosh, WI
National Provider Identifier
1528071990
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5139 Issued in WI
Practice address
1013 N Main St
Oshkosh, WI 54901-3837
Phone
(920) 428-5416
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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 5139 WI Primary

Addresses

Primary practice location

1013 N Main St
Oshkosh, WI 54901-3837

Mailing address

623 E Tallgrass Dr
Appleton, WI 54913-7505
Phone (920) 428-5416

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
I20150610002312 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1456579721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oshkosh Complete Dentistry LLC CurrentSince Jan 1, 2001 Accepting new patients
Dental Expressions SC CurrentSince Jan 17, 2022 Accepting new patients

Locations

1013 N Main St
Oshkosh, WI 54901
Phone (920) 235-0320

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1528071990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 E TALLGRASS DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137505",
            "telephone_number": "920-428-5416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 N MAIN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549013837",
            "telephone_number": "920-428-5416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIL",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.