Michael Robert Murphy Jr., DDS

Individual provider Active NPI Dentist · Phillips, WI

NPI 1699797134 · NPPES record last updated Apr 18, 2016

Key facts

NPI
1699797134
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
6619-15 (WI)
Practice address
605 Peterson Dr
Phillips, WI 54555-1430
Phone
(715) 339-3021
Fax
(715) 339-3022
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

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
I20140702001775 WI Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
1254556400

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0401008718VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Northwoods Dentistry, S.C. Dentist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401008718 VA
Dentist 122300000X 6619-15 WI Yes

Addresses

Primary practice location

605 Peterson Dr
Phillips, WI 54555-1430

Mailing address

PO Box 10
Phillips, WI 54555-0010
Phone (715) 339-3021

Other providers in Phillips, WI

All providers in Phillips, WI · Dentist in Wisconsin

Sources for this page

Verify at the official NPI Registry.