Michael Wayne Bennett II, DDS
Individual provider Active NPI Dentist · Rhinelander, WI
NPI 1700517315 · NPPES record last updated Mar 25, 2024
Key facts
- NPI
- 1700517315
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6001394-15 (WI)
- Practice address
- 2268 N Shore Dr
Rhinelander, WI 54501-8888 - Phone
- (725) 410-1400
- NPI assigned
- Jun 23, 2022
- Sex
- Male
- Sole proprietor
- No
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240916002277 | WI | Order and Referring Only - Dentist |
3476094624 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 6001394-15 | WI | Yes |
Addresses
Primary practice location
2268 N Shore Dr
Rhinelander, WI 54501-8888
Mailing address
172 W Hill Rd Apt 6
Rhinelander, WI 54501-2927
Phone (229) 449-0799
Other practice location 1
1650 Grand Concourse
Bronx, NY 10457
Phone (718) 590-1800
Other providers in Rhinelander, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.