Mdc West Bend, LLC
NPI 1497294722ActiveOrganization· Dentist· West Bend, WI
Dentist in West Bend, Wisconsin, registered in NPPES in February 2017, part of Modern Dental Care Holdings, LLC. The authorized official on file is Bernard Bolka, Member.
Overview
| NPI | 1497294722 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Modern Dental Care Holdings, LLC |
| NPI issued | Feb 20, 2017 |
| Last updated in NPPES | Feb 20, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | 5479015 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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