Active NPI
James Garrett Hines, D.M.D
- General Practice Dentistry
- Keshena, WI
National Provider Identifier
1801278890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1001140-15
- Practice address
- W3275 Wolf River Drive
Menominee Tribal Clinic
Keshena, WI 54135 - Phone
- (715) 799-3960
- NPI assigned
- Jun 25, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1001140-15 | WI | Primary |
Addresses
Primary practice location
W3275 Wolf River Drive
Menominee Tribal Clinic
Keshena, WI 54135
Mailing address
W3275 Wolf River Drive
Menominee Tribal Clinic
Keshena, WI 54135
Phone (715) 799-3960
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1001140-15 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435190400000",
"number": "1801278890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W3275 WOLF RIVER DRIVE",
"address_2": "MENOMINEE TRIBAL CLINIC",
"city": "KESHENA",
"state": "WI",
"postal_code": "54135",
"telephone_number": "715-799-3960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W3275 WOLF RIVER DRIVE",
"address_2": "MENOMINEE TRIBAL CLINIC",
"city": "KESHENA",
"state": "WI",
"postal_code": "54135",
"telephone_number": "715-799-3960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINES",
"first_name": "JAMES",
"middle_name": "GARRETT",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-25",
"last_updated": "2015-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "1001140-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keshena, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.