Individual provider Active NPI

Johann Hochstrasser, DDS

  • General Practice Dentistry
  • Elkhorn, WI
National Provider Identifier
1952533465
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1001132 Issued in WI
Practice address
1525 Fairway LN
Elkhorn, WI 53121-5000
Phone
(262) 723-3296
NPI assigned
Aug 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D9333 OR
General Practice Dentistry 1223G0001X 1001132 WI Primary

Addresses

Primary practice location

1525 Fairway LN
Elkhorn, WI 53121-5000

Mailing address

1525 Fairway LN
Elkhorn, WI 53121-5000
Phone (262) 723-3296

Other identifiers 1

IdentifierTypeStateIssuer
500609371MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160719000604 WI Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 5597058230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D9333ORMDDentist
1001132WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Elkhorn Family Dentistry LLC General Practice CurrentSince Jul 25, 2021 Accepting new patients

Locations

1525 Fairway Ln
Elkhorn, WI 53121
Phone (262) 723-3296

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": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1952533465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 FAIRWAY LN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531215000",
            "telephone_number": "262-723-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 FAIRWAY LN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531215000",
            "telephone_number": "262-723-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOCHSTRASSER",
        "first_name": "JOHANN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-17",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9333",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500609371",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, WI

Sources for this page

Verify at the official NPI Registry.