Zachary Walgenbach, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D13515 Issued in MN

Practice address

700 2ND St
Hudson, WI 54016

Phone

(715) 386-2515

Fax

(715) 381-5055

NPI assigned

Sep 11, 2015

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

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

Previously, effective Aug 17, 2016 through Aug 17, 2026

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 and National Provider Directory roles.

• Zachary C Walgenbach DDS SC

  • Dental Clinic/Center
  • Hudson, WI
  • NPI 1366188534
  NPD Authorized official
• Ling Family Dentistry

  • General Practice Dentistry
  • Blaine, MN
  • NPI 1053791319
  NPD (past) Authorized official

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1629446323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 2ND ST",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540161985",
            "telephone_number": "715-386-2515",
            "fax_number": "715-381-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 2ND ST",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "54016",
            "telephone_number": "715-386-2515",
            "fax_number": "715-381-5055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10945 Ulysses St NE",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554344185",
            "country_code": "US",
            "telephone_number": "763-784-1993",
            "fax_number": "763-784-1575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 2nd St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540161986",
            "country_code": "US",
            "telephone_number": "715-386-2515",
            "fax_number": "715-381-5055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALGENBACH",
        "first_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-11",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Marie Wagner, MS, CCC-SLP
• Jacqueline Rae Wagner, OTR/L
• Cortney Kim Wakefield, OTR/L
• Wal-Mart Stores East LP
• Jeryn Lee Waldera, BCBA
• Walgreen Co
• Terrance Mark Wallace, DC
• Carolyn M Wanken, DC
• Deanna M. Wanzek, PT
• Ward Chiropractic LLC

• General Practice Dentistry in Hudson, WI
• Providers in Hudson, 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 Mar 6, 2019; 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.