Glenn Wolfgang Haidinger, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6002219 Issued in WI

Practice address

75 Sherry Ave
Park Falls, WI 54552-1468

Phone

(715) 762-0200

NPI assigned

Jun 15, 2026

Sex

Male

Sole proprietor

No

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.

Medicare enrollment (NPD)

Enrolled

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.

• Family Health Center of Marshfield Inc

  • Federally Qualified Health Center (FQHC)
  • Park Falls, WI
  • NPI 1063104297
  NPD (past)
• Family Health Center of Marshfield Inc

  • Federally Qualified Health Center (FQHC)
  • Wisconsin Rapids, WI
  • NPI 1679447569
  NPD (past)

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

{
    "created_epoch": "1781481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1639004237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 6TH AVE S",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SHERRY AVE",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521468",
            "telephone_number": "715-762-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDINGER",
        "first_name": "GLENN",
        "middle_name": "WOLFGANG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-15",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6002219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flambeau Hospital, Inc.
• Kimberly Michelle Moreno Flores-Wilson
• Susan Fuerst, M.S., P.T.
• Sundayjoy Grajo Gican
• Anna Lynn Goetz, DDS
• Gina Georgeann Hansen, DMD
• Geoffrey S Harrison, MD
• Health Managment Consortium
• Teri Ann Henderson, COTA
• Diondra K Hilgart, COTA

• All providers in Park Falls, WI
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.

Verify at the official NPI Registry.