SOUTHWEST DENTAL GROUP, S.C. (NPI# 1003942319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003942319 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST DENTAL GROUP, S.C. |
| Practice Address |
2601 Taylor Ave Racine WI 53403-2865 |
| Practice Telephone | 2626323156 |
| Practice Fax Number | 2626323063 |
| Mailing Telephone | 2626323156 |
| Mailing Fax Number | 2626323063 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RICHARD L. DEFURIO (OWNER) |
| Authorized Official Telephone | 2626323156 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
2601 TAYLOR AVE |
| City | RACINE |
| State | WI |
| Zip Code | 53403-2865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396053732 | David Louis Defurio | Dentist | 2601 Taylor Ave, Racine, WI 53403-2865 | 2010-09-20 |
| 1932235769 | Stephen Nickolas Norovich | Dentist | 2601 Taylor Ave, Racine, WI 53403-2865 | 2007-02-26 |
| 1063548360 | Richard L. Defurio | Dentist | 2601 Taylor Ave, Racine, WI 53403-2865 | 2007-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124676259 | Quality Care LLC | Clinic/Center | 2051 Mead St, Racine, WI 53403 | 2019-09-02 |
| 1073999355 | Wisconsin Lutheran Child & Family Service, Inc. | Social Worker | 6150 Taylor Avenue, Racine, WI 53403 | 2015-08-10 |
| 1457780496 | Pheynell Branch | Counselor | 1650 Wasington Ave, Racine, WI 53403 | 2013-11-08 |
| 1811278054 | Michelle Gloria Parisot | Psychologist | 1320 Wisconsin Ave., Racine, WI 53403 | 2011-09-01 |
| 1720372022 | Katie Hagen | Social Worker | 1717 Taylor Avenue, Racine, WI 53403 | 2011-06-03 |
| 1043431570 | Rita S Harris | Physical Therapy Assistant | Lakeshore Manor 1320 Wisconsin Avenue, Racine, WI 53403 | 2007-05-01 |
| 1336281336 | Linda J Hockensmith | Occupational Therapist | 4214 Sheridan Road, Racine, WI 53403 | 2007-02-13 |
| 1851447387 | Richard John Kemper | Dentist | 1509 Washington Ave, Racine, WI 53403 | 2007-01-26 |
| 1689760332 | Lester Leslie Higgenbottom | Counselor | 1820 Arlington Ave, Racine, WI 53403 | 2006-10-04 |
| 1114942315 | Access Medical Center, LLC | Clinic/Center | 4216 Old Green Bay Rd, Racine, WI 53403 | 2006-07-12 |
| Find all providers in zip 53403 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| 1295148997 | Smita Kumar | Dentist | 4915 Washington Ave Ste B, Racine, WI 53406-4221 | 2014-06-10 |
| 1225282643 | James Allen Levandoski | Dentist | 239 Old Pine Cir, Racine, WI 53402-2305 | 2008-11-12 |
| 1679626915 | David Ramon Reesman | Dentist | 3900 North Bay Dr, Racine, WI 53402 | 2007-01-19 |
| 1497805964 | Robert Arnold Bissegger | Dentist | 3801 Washington Ave, Racine, WI 53405-2853 | 2007-01-10 |
| 1275699738 | Lisa Gabrius Fortunato | Dentist | 6218 Washington Ave, Suite C, Racine, WI 53406-3916 | 2006-12-29 |
| 1477622975 | Ned J Murphy | Dentist | 5440 Spring St, Racine, WI 53406-2912 | 2006-11-07 |
| 1235217589 | John Fortune Winkler | Dentist | 3333 Douglas Ave, Racine, WI 53402-3749 | 2006-11-02 |
| 1821176108 | Joseph Paul Sanfelippo | Dentist | 5814 Washington Ave, Racine, WI 53406-4020 | 2006-11-02 |
| 1629150289 | Margaret Aboagye | Dentist | 400 Lake Ave, Racine, WI 53403-1020 | 2006-10-20 |
| Find all providers in RACINE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.