Eric J Gabrielsen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6445-015 Issued in WI

Practice address

200 E. Bridge St.
Ste-100
Wausau, WI 54403

Phone

(713) 843-9800

Fax

(715) 843-9819

NPI assigned

Aug 11, 2009

Last updated

Apr 11, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Quirt Family Dentistry, SC

  dba Quirt Family Dentistry - Wausau

  • General Practice Dentistry
  • Wausau, WI
  • NPI 1235404732
  NPD (past)

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1982836813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E BRIDGE ST.",
            "address_2": "STE-100",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54403",
            "telephone_number": "713-843-9800",
            "fax_number": "715-843-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E. BRIDGE ST.",
            "address_2": "STE-100",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54403",
            "telephone_number": "713-843-9800",
            "fax_number": "715-843-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIELSEN",
        "first_name": "ERIC",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-11",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6445-15",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6445-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Ann Froom, SAC-IT
• Mary Frye
• Sandra Fuller Burton, LPC
• Joel L Furda, MD
• Shelley A Gabel-Lewis, MD
• Jessica Gaffaney, PA-C
• Hayley Gafford, PT
• Veronika Gagovic, M.D.
• L Ferdinand Galang, D.O.
• Luis C Galang, D.O.

• General Practice Dentistry in Wausau, WI
• Providers in Wausau, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.