William J. Baxa

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0003045 Issued in WI

Practice address

35791 Osseo Rd
Independence, WI 54747-9096

Phone

(715) 985-3316

Fax

(715) 985-2542

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baxa Dental Inc., S.C.

  • General Practice Dentistry
  • Independence, WI
  • NPI 1457361941
  Authorized official Same address or phone

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770695892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35791 OSSEO RD",
            "address_2": "PO BOX 550",
            "city": "INDEPENDENCE",
            "state": "WI",
            "postal_code": "547479096",
            "telephone_number": "715-985-3316",
            "fax_number": "715-985-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35791 OSSEO RD",
            "city": "INDEPENDENCE",
            "state": "WI",
            "postal_code": "547479096",
            "telephone_number": "715-985-3316",
            "fax_number": "715-985-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAXA",
        "first_name": "WILLIAM",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "0003045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS",
            "identifier": "76-993",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "391597408010",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33445800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baxa Dental Inc., S.C.
• Nicole Borreson
• County of Trempealeau (Apple Way Adult Family Home)
• County of Trempealeau (River Way North)
• County of Trempealeau (Clover Way RCAC)
• Gundersen Clinic, LTD.

• General Practice Dentistry in Independence, WI
• Providers in Independence, 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 Jul 8, 2007; 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.