Active NPI
Howard J Lubin, D.D.S.
- Public Health Dentistry
- Wautoma, WI
National Provider Identifier
1962823617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 3187-015
- Practice address
- 400 S Townline Rd
Wautoma, WI 54982-6922 - Phone
- (920) 787-5514
- Fax
- (920) 787-4737
- NPI assigned
- Dec 25, 2013
- 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 |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 3187-015 | WI | Primary |
Addresses
Primary practice location
400 S Townline Rd
Wautoma, WI 54982-6922
Mailing address
400 S Townline Rd
Wautoma, WI 54982-6922
Phone (920) 787-5514
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 |
|---|---|---|---|
| 3187-015 | WI | MD | Public Health Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387929600000",
"number": "1962823617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 S TOWNLINE RD",
"city": "WAUTOMA",
"state": "WI",
"postal_code": "549826922",
"telephone_number": "920-787-5514",
"fax_number": "920-787-4737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S TOWNLINE RD",
"city": "WAUTOMA",
"state": "WI",
"postal_code": "549826922",
"telephone_number": "920-787-5514",
"fax_number": "920-787-4737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUBIN",
"first_name": "HOWARD",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-12-25",
"last_updated": "2013-12-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "WI",
"license": "3187-015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wautoma, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 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.