Active NPI
Jeffrey Jon Duenk, DDS
- Dentist
- Cedar Grove, WI
National Provider Identifier
1922267434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3595015
- Practice address
- 608 S Elm
Cedar Grove, WI 53013 - Phone
- (920) 668-8546
- NPI assigned
- Jun 9, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3595015 | WI | Primary |
Addresses
Primary practice location
608 S Elm
Cedar Grove, WI 53013
Mailing address
608 S Elm
PO Box 320
Cedar Grove, WI 53013
Phone (920) 668-8546
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3595015 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212969600000",
"number": "1922267434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "608 S ELM",
"address_2": "PO BOX 320",
"city": "CEDAR GROVE",
"state": "WI",
"postal_code": "53013",
"telephone_number": "920-668-8546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "608 S ELM",
"city": "CEDAR GROVE",
"state": "WI",
"postal_code": "53013",
"telephone_number": "920-668-8546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUENK",
"first_name": "JEFFREY",
"middle_name": "JON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-09",
"last_updated": "2008-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "3595015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Grove, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.