Active NPI
Felix Wangsawihardja, D.M.D.
- General Practice Dentistry
- Verona, WI
National Provider Identifier
1992298400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1001857-15
- Practice address
- 927 N Main St
Verona, WI 53593-1913 - Phone
- (608) 848-2000
- NPI assigned
- Jun 8, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1001857-15 | WI | Primary |
Addresses
Primary practice location
927 N Main St
Verona, WI 53593-1913
Mailing address
440 Science Dr Ste 100
Madison, WI 53711-1064
Phone (608) 308-2950
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1001857-15 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Felix Wangsawihardja, DMD, PLLC | General Practice | Current | Accepting new patients |
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.
-
- General Practice Dentistry
- Dallas, TX
- NPI 1205775566
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528416000000",
"number": "1992298400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 SCIENCE DR STE 100",
"city": "MADISON",
"state": "WI",
"postal_code": "537111064",
"telephone_number": "608-308-2950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "927 N MAIN ST",
"city": "VERONA",
"state": "WI",
"postal_code": "535931913",
"telephone_number": "608-848-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANGSAWIHARDJA",
"first_name": "FELIX",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-08",
"last_updated": "2018-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "1001857-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Verona, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.