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DR. LIBERTY ANN BOUCHER DDS
NPI 1114183126
Dentist - General Practice in Glendale, WI

Active since July 30, 2008PECOS Enrolled
7040 N PORT WASHINGTON RD, GLENDALE, WI 53217(414) 351-6010 Get Directions Write a Review

NPPES record last updated: July 30, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Liberty Ann Boucher Dds NPPES

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

DR. LIBERTY ANN BOUCHER DDS (NPI 1114183126) is an individual general practice provider in Glendale, Wisconsin, licensed in Wisconsin (6297-15) and active in the NPI registry since July 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114183126
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. LIBERTY ANN BOUCHERCredential: DDS
Location Address7040 N PORT WASHINGTON RDGlendale, WI 53217-3838
Mailing Address4037 N Downer AveShorewood, WI 53211-2127 · (414) 418-2280
Phone(414) 351-6010
Sole ProprietorNo
Enumeration DateJuly 30, 2008
✔ NPI 1114183126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in WI · 6297-15
Definition
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.
7040 N PORT WASHINGTON RD, Glendale, WI 53217
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Wisconsin, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Liberty Ann Boucher Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53217 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 10

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

FOREFRONT DERMATOLOGY, S.C.
Dermatology
7040 N PORT WASHINGTON RD, SUITE 404
GLENDALE, WI 53217
Milwaukee County (414) 355-2405
DR. JAMES LIPINSKI
Dentist (Orthodontics and Dentofacial Orthopedics)
7040 N PORT WASHINGTON RD, STE 414
GLENDALE, WI 53217
Milwaukee County (414) 351-6551
DR. JOHN MICHAEL WERWIE DDS
Dentist (General Practice)
7040 N PORT WASHINGTON RD, FORWARD DENTAL
GLENDALE, WI 53217
Milwaukee County (414) 351-6010
JOSEPH L GAFFNEY D.D.S
Dentist (Endodontics)
7040 N PORT WASHINGTON RD
GLENDALE, WI 53217
Milwaukee County (414) 651-6010
NORTHEAST OBGYN SC
Obstetrics & Gynecology
7040 N PORT WASHINGTON RD, SUITE 400
GLENDALE, WI 53217
Milwaukee County (414) 228-8888
DR. JAMES EDWARD BERMAN M.D.
Dermatology
7040 N PORT WASHINGTON RD, SUITE 404
GLENDALE, WI 53217
Milwaukee County (414) 355-2405
PETROU-HAEFS EYECARE, LLC
Clinic/Center
7040 N PORT WASHINGTON RD, SUITE 420
GLENDALE, WI 53217
Milwaukee County (414) 839-8379
DR. CHRISTINA MARIE PETROU O.D.
Optometrist
7040 N PORT WASHINGTON RD, SUITE 420
GLENDALE, WI 53217
Milwaukee County (414) 247-2020

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 Liberty Boucher's NPI number?

The NPI number for Liberty Boucher is 1114183126. It was assigned to this individual provider in the NPPES registry on July 30, 2008.

Where is Liberty Boucher located?

Liberty Boucher practices at 7040 N Port Washington Rd, Glendale, WI 53217. The listed phone number is (414) 351-6010.

What is Liberty Boucher's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Liberty Boucher enrolled in Medicare?

Yes. Liberty Boucher is registered in the Medicare PECOS enrollment system.

What insurance does Liberty Boucher accept?

Health plans from Delta Dental of Wisconsin, Inc. list Liberty Boucher as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Liberty Boucher was last updated on July 30, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.