Individual provider Active NPI

David L Kujak, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Onalaska, WI
National Provider Identifier
1902056872
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
6949 Issued in WI
Practice address
1845 E Main St
Onalaska, WI 54650-8668
Phone
(608) 783-8333
Fax
(608) 783-5942
NPI assigned
Sep 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8676 KY
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DS9252 TN
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 6949 WI Primary

Addresses

Primary practice location

1845 E Main St
Onalaska, WI 54650-8668

Mailing address

1845 E Main St
Onalaska, WI 54650-8668
Phone (608) 783-8333

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8676KYMDDentist
DS9252TNMDOrthodontics and Dentofacial Orthopedic Dentist
6949WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthodontic Specialists of Onalaska and the Coulee Region Orthodontics and Dentofacial Orthopedics Current Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1902056872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 E MAIN ST",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508668",
            "telephone_number": "608-783-8333",
            "fax_number": "608-783-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 E MAIN ST",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508668",
            "telephone_number": "608-783-8333",
            "fax_number": "608-783-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUJAK",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-26",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8676",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "DS9252",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "6949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.