Individual provider Active NPI

Adam Pasono, D.D.S.

  • Dentist
  • Green Bay, WI
National Provider Identifier
1811307408
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7233-15 Issued in WI
Practice address
2313 S Webster Ave
Green Bay, WI 54301-2159
Phone
(920) 432-8492
NPI assigned
May 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7233-15 WI Primary

Addresses

Primary practice location

2313 S Webster Ave
Green Bay, WI 54301-2159

Mailing address

1983 Scheuring Road
8
De Pere, WI 54115-3465
Phone (920) 639-1215

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150615000655 WI Order and Referring Only - DentistPractitioner - Dentist 0648581827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7233-15WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Breeze Dental, LLC Current Accepting new patients
Harbor View Dentistry Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1811307408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1983 SCHEURING ROAD",
            "address_2": "8",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541153465",
            "telephone_number": "920-639-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012159",
            "telephone_number": "920-432-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASONO",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "7233-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.