Individual provider Active NPI

Lawrence Volkert, DDS

  • Dentist
  • Sturtevant, WI
National Provider Identifier
1710170626
Registry record updated Aug 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3742 Issued in WI
Practice address
2753 Wisconsin Street
Sturtevant, WI 53177
Phone
(262) 886-4203
NPI assigned
Aug 23, 2007
Last updated
Aug 23, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3742 WI Primary

Addresses

Primary practice location

2753 Wisconsin Street
Sturtevant, WI 53177

Mailing address

2753 Wisconsin Street
Sturtevant, WI 53177
Phone (262) 886-4203

Other identifiers 1

IdentifierTypeStateIssuer
33495000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3742WIMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187827200000",
    "number": "1710170626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2753 WISCONSIN STREET",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "53177",
            "telephone_number": "262-886-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2753 WISCONSIN STREET",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "53177",
            "telephone_number": "262-886-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLKERT",
        "first_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2007-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "3742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33495000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturtevant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.