William Robert Baggott, DDS

Individual provider Active NPI General Practice Dentistry · Greenfield, WI

NPI 1851486484 · NPPES record last updated Jun 1, 2011

Key facts

NPI
1851486484
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2737 (WI)
Practice address
3365 S 103 St
Suite 220
Greenfield, WI 53227
Phone
(414) 543-9911
Fax
(414) 543-9911
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20141222000794 WI Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
6800119991

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2737WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Baggott Dental, LLC Past
since Jul 31, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2737 WI Yes

Addresses

Primary practice location

3365 S 103 St
Suite 220
Greenfield, WI 53227

Mailing address

3365 S 103 St
Suite 220
Greenfield, WI 53227
Phone (414) 543-9911

Other identifiers

IdentifierTypeStateIssuer
33429300MedicaidWI

Other providers in Greenfield, WI

All providers in Greenfield, WI · General Practice Dentistry in Wisconsin

Sources for this page

Verify at the official NPI Registry.