Thomas Exner, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

6756-15 Issued in WI

Practice address

2314 N Grandview Blvd Ste 203
Waukesha, WI 53188-1675

Phone

(262) 542-1513

NPI assigned

Jun 30, 2011

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

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

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1679860415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 N GRANDVIEW BLVD STE 203",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 N GRANDVIEW BLVD STE 203",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881675",
            "telephone_number": "262-542-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EXNER",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6756-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Everside Health, LLC
• Amber L Evonovich, RDH
• Jillian Louise Ewing Haas, M.D.
• Albert Charles Exner, D.D.S.
• Emma Louise Exner, SAC-IT, CSW
• Eye Clinic of Waukesha LLC
• Nathaniel D Fagan-Duerr, MSN, APNP, FNP-C
• Allison Fahey, APNP
• Joseph L Fahl, D.D.S.
• Kay Andrea Fahl, RDH

• Dentist in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.