Michael Patrick Reilly, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5793015 Issued in WI

Practice address

1018 King Rd
Tomahawk, WI 54487

Phone

(715) 453-7071

Fax

(715) 453-9461

NPI assigned

Jun 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Aug 3, 2020 through Aug 3, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Reilly Dental, LLC

  • General Practice Dentistry
  • Tomahawk, WI
  • NPI 1063615342
  NPD (past) Authorized official

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912100280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "54487",
            "telephone_number": "715-453-7071",
            "fax_number": "715-453-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 KING RD",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "54487",
            "telephone_number": "715-453-7071",
            "fax_number": "715-453-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5793015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Psychological Resource Center LLC
• Lee W Purdy, O.D.
• Reilly Dental, LLC
• Dewey Irving Reilly, DDS
• Dewey Nickels Reilly, DDS
• Rhonda J Repinski, APNP
• Ciana Marie Rose
• Ruthanne Lydia Rosser, P.T.
• Buddy Mark Rumsey, D.C.
• Kim Louise Rumsey, D.C.

• Dentist in Tomahawk, WI
• Providers in Tomahawk, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.