DR. AUSTIN ALLEN IVERSON DMD
NPI 1023670254
Dentist in Port Washington, WI

Active since July 09, 2019Opted out of Medicare · through Feb 5, 2028
1349 W GRAND AVE, PORT WASHINGTON, WI 53074(262) 284-5505 Get Directions Write a Review

NPPES record last updated: April 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 7, 2023, Nov 4, 2019, Jul 9, 2019 (3 updates tracked since 2019).

About Dr. Austin Allen Iverson Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. AUSTIN ALLEN IVERSON DMD (NPI 1023670254) is an individual dentist in Port Washington, Wisconsin, licensed in Wisconsin (1002153-15) and active in the NPI registry since July 2019. He has opted out of Medicare through February 5, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1023670254
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. AUSTIN ALLEN IVERSONCredential: DMD
Location Address1349 W GRAND AVEPort Washington, WI 53074-2043
Mailing Address1349 W Grand AvePort Washington, WI 53074-2043 · (262) 284-5505
Sole ProprietorNo
Enumeration DateJuly 9, 2019
Last NPPES UpdateApril 7, 20233 updates tracked since enumeration
NPPES CertifiedApril 7, 2023
NPI 1023670254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License Licensed in WI · 1002153-15
Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1349 W GRAND AVE, Port Washington, WI 53074

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Austin Allen Iverson Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 5, 2020 through February 5, 2028.

Opt-Out Effective DateFebruary 5, 2020
Opt-Out In Effect ThroughFebruary 5, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53074 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
1349 W GRAND AVE
PORT WASHINGTON, WI 53074
Clinic/Center (Dental)
1349 W GRAND AVE
PORT WASHINGTON, WI 53074

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Austin Iverson's NPI number?

The NPI number for Austin Iverson is 1023670254. It was assigned to this individual provider in the NPPES registry on July 9, 2019.

Where is Austin Iverson located?

Austin Iverson practices at 1349 W Grand Ave, Port Washington, WI 53074. The listed phone number is (262) 284-5505.

What is Austin Iverson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Austin Iverson enrolled in Medicare?

No. Austin Iverson has opted out of Medicare through February 5, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Austin Iverson was last updated on April 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.