Michael D Auvinen, DDS, MAGD

Individual provider Active NPI Dentist · Ashland, WI

NPI 1679639504 · NPPES record last updated Mar 7, 2023

Key facts

NPI
1679639504
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
5671 (WI)
Practice address
615 Lake Shore Dr W
Ashland, WI 54806-1507
Phone
(715) 682-2811
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20141120000533 WI Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
0446472831

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5671WIMDDentist
5671 015 EWIWIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Dental Center, SC General Practice Past
since Dec 6, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5671 015 EWI WI
Dentist 122300000X 5671 WI Yes

Addresses

Primary practice location

615 Lake Shore Dr W
Ashland, WI 54806-1507

Mailing address

615 Lake Shore Dr W
Ashland, WI 54806-1507
Phone (715) 682-2811

Other providers in Ashland, WI

All providers in Ashland, WI · Dentist in Wisconsin

Sources for this page

Verify at the official NPI Registry.