Individual provider Active NPI

Anthony John Budzinski, DDS,MS

  • Dentist
  • Racine, WI
National Provider Identifier
1568675676
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3336 Issued in WI
Practice address
2510 Erie St
Racine, WI 53402-4414
Phone
(262) 681-1898
Fax
(262) 681-2058
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3336 WI Primary

Addresses

Primary practice location

2510 Erie St
Racine, WI 53402-4414

Mailing address

2510 Erie St
Racine, WI 53402-4414
Phone (262) 681-1898

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160509000958 WI Order and Referring Only - Other (Non-Physician) 7911206263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3336WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568675676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 ERIE ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534024414",
            "telephone_number": "262-681-1898",
            "fax_number": "262-681-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 ERIE ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534024414",
            "telephone_number": "262-681-1898",
            "fax_number": "262-681-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDZINSKI",
        "first_name": "ANTHONY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "3336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

Verify at the official NPI Registry.