Dr Joel A Supita, DDS is a medicare enrolled "Dentist - General Practice" provider in Crivitz, Wisconsin. His current practice location is
519 N Us Highway 141, Crivitz, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(715) 854-7545.
Dr Joel A Supita is licensed to practice in Wisconsin (license number 2824-015) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1922051895.
Healthcare Provider's Profile
Full Name | Dr Joel A Supita |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 519 N Us Highway 141, Crivitz, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1922051895
- Provider Enumeration Date: 05/19/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 2062739113
- Enrollment ID: I20150330000477
Medical Identifiers
Medical identifiers for Dr Joel A Supita such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1922051895 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 2824-015 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Joel A Supita is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Joel A Supita, DDS W7592 E 26th Rd, Crivitz, WI 54114-7366 Ph: (715) 854-7409 | Dr Joel A Supita, DDS 519 N Us Highway 141, Crivitz, WI 54114-1639 Ph: (715) 854-7545 |
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