Glen Alfred Magyera, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

WI2735 Issued in WI

Practice address

3216 Business Park Drive
Stevens Point, WI 54481

Phone

(715) 341-7171

Fax

(715) 341-5160

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619001609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 BUSINESS PARK DR",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544818838",
            "telephone_number": "715-341-7171",
            "fax_number": "715-341-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 BUSINESS PARK DRIVE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481",
            "telephone_number": "715-341-7171",
            "fax_number": "715-341-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGYERA",
        "first_name": "GLEN",
        "middle_name": "ALFRED",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "WI2735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33426700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy L Macewicz, PT
• Lindsey M Mackay, PT
• Troy A Madlena, DPT
• Harry J Magee, MD
• Katy Ann Magnussen, LMT
• Erin Mahoney, PHARMD
• Philip M Mahoney, PAC
• Zachary James Mancl, PT
• Tori Mandeville, MA, LPC
• Dominee M Manzon, MD

• Dentist in Stevens Point, WI
• Providers in Stevens Point, WI by specialty
• Dentist 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.