Active NPI
Dan J Gholson, DDS
- Periodontics
- Onalaska, WI
National Provider Identifier
1609814540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 2363
- Practice address
- 2850 Midwest Dr
Suite 102
Onalaska, WI 54650-6732 - Phone
- (608) 782-0140
- Fax
- (608) 785-7610
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 2363 | WI | Primary |
Addresses
Primary practice location
2850 Midwest Dr
Suite 102
Onalaska, WI 54650-6732
Mailing address
2850 Midwest Dr
Suite 102
Onalaska, WI 54650-6732
Phone (608) 782-0140
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2363 | WI | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1609814540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2850 MIDWEST DR",
"address_2": "SUITE 102",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546506732",
"telephone_number": "608-782-0140",
"fax_number": "608-785-7610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2850 MIDWEST DR",
"address_2": "SUITE 102",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546506732",
"telephone_number": "608-782-0140",
"fax_number": "608-785-7610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHOLSON",
"first_name": "DAN",
"middle_name": "J",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "WI",
"license": "2363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Onalaska, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.