Rebecca Havel Prust, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5658-015 Issued in WI

Practice address

1223 Lake Street
Algoma, WI 54201

Phone

(920) 487-5648

Fax

(920) 487-5658

NPI assigned

Mar 5, 2007

Last updated

Apr 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Rebecca Ann Havel Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Algoma Lakeview Dental Care, S.C.

  • General Practice Dentistry
  • Algoma, WI
  • NPI 1700130648
  NPD (past) Authorized official

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1609905645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 LAKE STREET",
            "city": "ALGOMA",
            "state": "WI",
            "postal_code": "54201",
            "telephone_number": "920-469-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 LAKE STREET",
            "city": "ALGOMA",
            "state": "WI",
            "postal_code": "54201",
            "telephone_number": "920-487-5648",
            "fax_number": "920-487-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUST",
        "first_name": "REBECCA",
        "middle_name": "HAVEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5658-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "HAVEL",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katie Ann Lukes, APNP
• Lynne M Lukes, PTA
• Ralph Bradley Nelson, D.O.
• Oconto Hospital & Medical Center Inc (Emplify Health Algoma Clinic)
• Lisa Olson, PHYSICIAN ASSISTANT
• Rachel Marie Salzsieder, RN
• Mark John Sauter, DC
• Tina M Schmidt, PA
• Lori Schuerman, MPH, DNP,APNP, PMHNP
• Secrest Family Chiropractic LLC

• General Practice Dentistry in Algoma, WI
• Providers in Algoma, 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 Apr 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.