Individual provider Active NPI

Charles Frank Vento, DDS

  • Dentist
  • Mukwonago, WI
National Provider Identifier
1528293321
Registry record updated May 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6376-15 Issued in WI
Practice address
1210 Marsh View Dr
Mukwonago, WI 53149-7700
Phone
(262) 363-4041
NPI assigned
May 21, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6376-15 WI Primary

Addresses

Primary practice location

1210 Marsh View Dr
Mukwonago, WI 53149-7700

Mailing address

2732 Northview Rd Unit 78
Waukesha, WI 53188-2036
Phone (414) 659-0691

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
I20160516001758 WI Order and Referring Only - DentistPractitioner - Dentist 8224327184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6376-15WIMDDentist
6376WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242864000000",
    "number": "1528293321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2732 NORTHVIEW RD UNIT 78",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882036",
            "telephone_number": "414-659-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 MARSH VIEW DR",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531497700",
            "telephone_number": "262-363-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTO",
        "first_name": "CHARLES",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-21",
        "last_updated": "2009-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6376-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukwonago, WI

Sources for this page

Verify at the official NPI Registry.