Alisha Kay Koxlien, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1001302-15 Issued in WI

Practice address

19815 E Gale Ave
Galesville, WI 54630-7313

Phone

(608) 582-4115

NPI assigned

May 26, 2016

Last updated

May 26, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1750739082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N20777 US HIGHWAY 53",
            "city": "GALESVILLE",
            "state": "WI",
            "postal_code": "546308634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19815 E GALE AVE",
            "city": "GALESVILLE",
            "state": "WI",
            "postal_code": "546307313",
            "telephone_number": "608-582-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOXLIEN",
        "first_name": "ALISHA",
        "middle_name": "KAY",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001302-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Galesville LTC Pharmay LLC (Galesville LTC Pharmacy)
• Gundersen Clinic, LTD
• Christine Kathryn Hoffmann, RD
• Heather Anne Marie James
• Gerald Francis Jennings
• Galen Roy Koxlien, DDS
• Garet R Koxlien, DMD
• Shannon Lea Kramer, CNM
• Annalese Lamke
• Brittany Malesytcki

• General Practice Dentistry in Galesville, WI
• Providers in Galesville, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.