Michael A Bender, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3783015 Issued in WI

Practice address

201 Sherman Ave West
Fort Atkinson, WI 53538

Phone

(920) 563-7323

Fax

(920) 563-7612

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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 and National Provider Directory roles.

• 201 Water Front Dental LLC

  • General Practice Dentistry
  • Fort Atkinson, WI
  • NPI 1902912165
  NPD (past) Authorized official

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588770747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SHERMAN AVE WEST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "53538",
            "telephone_number": "920-563-7323",
            "fax_number": "920-563-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SHERMAN AVE WEST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "53538",
            "telephone_number": "920-563-7323",
            "fax_number": "920-563-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDER",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3783015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33496600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine E Beckman, LCSW
• Bedrock HCS at Atkinson LLC
• Kimberly Beggs, LAT
• Kristen Emily Behl, DPT
• Stephanie P Belzer, APSW
• Carter Alan Bernier, DPT
• Debra Lynn Bingham, CRNA
• Eric Clark Bingner, CRNA
• Nicholas J Bisenius, PHD
• Ryann Bixler, RDH

• General Practice Dentistry in Fort Atkinson, WI
• Providers in Fort Atkinson, 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.