DR. JACK RALPH WILLERT D.D.S. NPI 1811033343

NPI Information

  • NPI: 1811033343
  • Provider Name: DR. JACK RALPH WILLERT, D.D.S.
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1835 W POINTE DR
    OSHKOSH, WI
    ZIP 54902
  • Phone: (920) 231-3140

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NPI Details

DR. Jack Ralph Willert, D.D.S. is a general practice dentist in Oshkosh, WI. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Jack Ralph Willert, D.D.S. NPI is 1811033343. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1835 W POINTE DR
OSHKOSH, WI
ZIP 54902-174
Phone: (920) 231-3140
Fax: (920) 231-5040

The NPI 1811033343 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 1/30/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice5001833WISCONSINYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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