Active NPI
Ronald Brian Sershon, D.D.S.
- Dentist
- Chippewa Falls, WI
National Provider Identifier
1528137064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6287-15
- Practice address
- 2909 E. Park Ave.
Cvctf Hsu Dental
Chippewa Falls, WI 54729 - Phone
- (608) 739-2690
- NPI assigned
- Nov 7, 2006
- Last updated
- Dec 3, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6287-15 | WI | Primary |
| General Practice Dentistry | 1223G0001X | 019018687 | IL |
Addresses
Primary practice location
2909 E. Park Ave.
Cvctf Hsu Dental
Chippewa Falls, WI 54729
Mailing address
2909 E. Park Ave.
Cvctf Hsu Dental
Chippewa Falls, WI 54729
Phone (608) 739-2690
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6287-15 | WI | MD | Dentist |
| 019018687 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386028800000",
"number": "1528137064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2909 E. PARK AVE.",
"address_2": "CVCTF HSU DENTAL",
"city": "CHIPPEWA FALLS",
"state": "WI",
"postal_code": "54729",
"telephone_number": "608-739-2690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2909 E. PARK AVE.",
"address_2": "CVCTF HSU DENTAL",
"city": "CHIPPEWA FALLS",
"state": "WI",
"postal_code": "54729",
"telephone_number": "608-739-2690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERSHON",
"first_name": "RONALD",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2013-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "6287-15",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019018687",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chippewa Falls, WI
- Second Springs Care LLC
- Monica Seiberling, OTR/CHT
- Kristen Lee Seidler, MS, SAC, PC-IT
- Serenity House Inc.
- Brian J. Serres, DDS
- Mary E Shea, PT
- Jeffrey Shepich, MD
- Mechele Lee Shipman, EDD, MSW, LCISW LCSW
- Shopko Stores Operating Co LLC (ShopKo Pharmacy 037)
- Shopko Stores Operating Co. LLC (ShopKo Optical 037)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.