Individual provider Active NPI

David S Ducommun, D.D.S.

  • Dentist
  • Middleton, WI
National Provider Identifier
1619039237
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4199 Issued in WI
Practice address
7507 Hubbard Ave Ste 101
Middleton, WI 53562-3135
Phone
(608) 836-5700
Fax
(608) 836-4621
NPI assigned
Dec 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4199 WI Primary

Addresses

Primary practice location

7507 Hubbard Ave Ste 101
Middleton, WI 53562-3135

Mailing address

7507 Hubbard Ave #101
Middleton, WI 53562-3135
Phone (608) 836-5700

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160224001338 WI Order and Referring Only - DentistPractitioner - Dentist 8527363894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619039237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7507 HUBBARD AVE #101",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623135",
            "telephone_number": "608-836-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7507 HUBBARD AVE STE 101",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623135",
            "telephone_number": "608-836-5700",
            "fax_number": "608-836-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCOMMUN",
        "first_name": "DAVID",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

Verify at the official NPI Registry.