David Paulson, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D13705 Issued in MN

Practice address

1610 Maxwell Dr Ste 100
Hudson, WI 54016-8724

Phone

(715) 690-3050

NPI assigned

Apr 19, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 16, 2023 through Feb 16, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1598119273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 MAXWELL DR STE 100",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168724",
            "telephone_number": "715-495-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 MAXWELL DR STE 100",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168724",
            "telephone_number": "715-690-3050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2036 Robert St S",
            "address_purpose": "LOCATION",
            "city": "West St Paul",
            "state": "MN",
            "postal_code": "551183923",
            "country_code": "US",
            "telephone_number": "651-633-4216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Delaware St SE",
            "address_2": "7-360",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550357",
            "country_code": "US",
            "telephone_number": "715-495-0554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAULSON",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13705",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MN",
            "license": "D13705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Steven Oswald, D.C.
• Melissa Anne Otto, PT, DPT
• Pamela J. Henkel D.B.a. Hudson Counseling Services
• Gerald Parupsky, O.D.
• Pathways Family Chiropractic, Inc.
• Holly Marie Paulson, OTRL
• PDG, P.a.
• Peaceful Living , LLC
• Peak Vestibular Center LLC
• Lori Pedersen, P.T.

• Periodontics in Hudson, WI
• Providers in Hudson, WI by specialty
• Periodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.