Tiffany F Birrenkott, DDS
Individual provider Active NPI General Practice Dentistry · Baraboo, WI
NPI 1881760601 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1881760601
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5023 (WI)
- Practice address
- 880 14TH St
Baraboo, WI 53913-1540 - Phone
- (608) 356-6611
- NPI assigned
- Nov 24, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150804004247 | WI | Order and Referring Only - Dentist |
5092029033 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Associates of Baraboo, S.C. | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5023 | WI | Yes |
Addresses
Primary practice location
880 14TH St
Baraboo, WI 53913-1540
Mailing address
880 14TH St
P.O. Bix 558
Baraboo, WI 53913-1540
Phone (608) 356-6611
Other providers in Baraboo, WI
- Ellen Marie Bergendahl
- Gail Pilch Bergeson
- Rosalee Anne Bertram
- Sarah Rose Beuthin
- Bio-Medical Applications of Wisconsin, Inc.
- Bradley J Bjorklund
- Kara A Bjorklund
- Jamie L Bockhop
- Alana Claire Bongard
- Renee Boone
All providers in Baraboo, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.