Provider Demographics
NPI:1790886208
Name:MEISTER, RICHARD D (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:D
Last Name:MEISTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 BUCKHORN RD
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:WI
Mailing Address - Zip Code:54568-9811
Mailing Address - Country:US
Mailing Address - Phone:608-289-2138
Mailing Address - Fax:
Practice Address - Street 1:1602 N RANDALL AVE
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-1124
Practice Address - Country:US
Practice Address - Phone:608-756-8744
Practice Address - Fax:608-756-5344
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47841223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1014179OtherPHYSICIAN'S PLUS INSURANC
WI11198OtherDEAN HEALTH INSURANCE
WIBM4974095OtherDEA NUMBER
WI11198OtherDEAN HEALTH INSURANCE
WIU61046Medicare UPIN
WIBM4839621OtherDEA NUMBER