Richard Vincent Whalen III, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5255015 Issued in WI

Practice address

261 North Main Street
Dousman, WI 53118-0187

Phone

(262) 965-3662

Fax

(262) 965-3627

NPI assigned

Mar 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dousman Family Dentistry

  • General Practice Dentistry
  • Dousman, WI
  • NPI 1811025364
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558499236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 NORTH MAIN STREET",
            "city": "DOUSMAN",
            "state": "WI",
            "postal_code": "531180187",
            "telephone_number": "262-965-3662",
            "fax_number": "262-965-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 NORTH MAIN STREET",
            "city": "DOUSMAN",
            "state": "WI",
            "postal_code": "531180187",
            "telephone_number": "262-965-3662",
            "fax_number": "262-965-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEN",
        "first_name": "RICHARD",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5255015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Michael Smith, LPC-IT
• Emily Ann Steckbauer
• Maraleta Swenson
• Amy Vertz
• George Vohwinkle, LCSW
• Wisconsin Masonic Home Inc (Compass Point)
• Wisconsin Masonic Home Inc

• General Practice Dentistry in Dousman, WI
• Providers in Dousman, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.