Dean R Hussong, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5002144-015 Issued in WI

Practice address

10 Bradley Farm Rd
Tomahawk, WI 54487-1563

Phone

(715) 453-5321

NPI assigned

Apr 18, 2007

Last updated

Jul 9, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 17, 2008 through Jul 17, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dean R. Hussong, DDS, SC

  • General Practice Dentistry
  • Tomahawk, WI
  • NPI 1336365949
  NPD (past) Authorized official
• Tomahawk Family Dental LLC

  • Dental Clinic/Center
  • Tomahawk, WI
  • NPI 1639896814
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790901395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BRADLEY FARM RD",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "544871563",
            "telephone_number": "715-453-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BRADLEY FARM RD",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "544871563",
            "telephone_number": "715-453-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSONG",
        "first_name": "DEAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5002144-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33377200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Hofschulte, DPT
• Wendy Anne Hoover, FNLP
• Mia Hoveland, DPT
• Whitney Marie Hribar, PT, DPT
• Human Services Board Serving North Central Heatlh Care (North Central Health Care)
• Joshua Drew Ice, LAT
• Victor Ierulli, MD
• Robert David Imm, DDS
• Amy Marie Imme
• Innate Life LLC (Innate Life)

• General Practice Dentistry in Tomahawk, WI
• Providers in Tomahawk, 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 9, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.