NORTHERN DOOR DENTAL SC (NPI# 1013038207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013038207 |
| Entity Type | Organization |
| Organization Name | NORTHERN DOOR DENTAL SC |
| Practice Address |
10589 S Highland Rd Ste 4 Sister Bay WI 54234 |
| Practice Telephone | 9208545200 |
| Practice Fax Number | 9208547601 |
| Mailing Telephone | 9208545200 |
| Mailing Fax Number | 9208547601 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-07-30 |
| Authorized Official Name | DR. THOMAS MALCOLM MAYHEW III (DENTIST PRACTICE PRESIDENT OWNER) |
| Authorized Official Telephone | 9208545200 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5002020015 | WI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33368800 | 05 |
| Street Address |
10589 S HIGHLAND RD STE 4 |
| City | SISTER BAY |
| State | WI |
| Zip Code | 54234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790940674 | Thomas M Mayhew | Dentist | 10589 S Highland Dr, Ste 4, Sister Bay, WI 54234 | 2008-07-21 |
| 1598974990 | Elizabeth Ann Jorgenson | Chiropractor | 275 Smith Drive, Sister Bay, WI 54234 | 2007-05-22 |
| 1841404969 | C Thomas Wilson | Dentist | 703 S Bay Shore Dr, Suite #4, Sister Bay, WI 54234 | 2007-05-09 |
| 1992839641 | Martha L Coventry | Nurse Practitioner | 10539 Applewood Road, Sister Bay, WI 54234 | 2007-03-15 |
| 1215080080 | Deborah Marie Webber | Chiropractor | 803 S Bayshore Dr, Sister Bay, WI 54234 | 2007-01-18 |
| 1427163500 | Michael F Flood | Physician Assistant | 2521 S Bay Shore Dr, Sister Bay, WI 54234 | 2006-08-20 |
| 1699771345 | Timothy D. Tishler | Dentist | 2596 S. Bay Shore Dr., Sister Bay, WI 54234 | 2005-06-27 |
| 1821296146 | Daniel B Anderson | Dentist | 703 S Bay Shore Dr, Sister Bay, WI 54234 | 2007-07-09 |
| 1114049202 | Joan A. Traver,md | Internal Medicine | 10539 Applewood Rd, Sister Bay, WI 54234-9004 | 2007-04-06 |
| 1588750574 | Joan Amelia Traver | Internal Medicine | 10539 Applewood Dr, Sister Bay, WI 54234-9004 | 2006-10-05 |
| Find all providers in zip 54234 | ||||
| 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 |
|---|---|---|---|---|
| 1790940674 | Thomas M Mayhew | Dentist | 10589 S Highland Dr, Ste 4, Sister Bay, WI 54234 | 2008-07-21 |
| 1841404969 | C Thomas Wilson | Dentist | 703 S Bay Shore Dr, Suite #4, Sister Bay, WI 54234 | 2007-05-09 |
| 1699771345 | Timothy D. Tishler | Dentist | 2596 S. Bay Shore Dr., Sister Bay, WI 54234 | 2005-06-27 |
| 1821296146 | Daniel B Anderson | Dentist | 703 S Bay Shore Dr, Sister Bay, WI 54234 | 2007-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700496007 | Elizabeth R Friend | Dentist | 440 Science Dr Ste 100, Madison, WI 53711-1064 | 2020-08-03 |
| 1205451598 | Tysen Wood | Dentist | 605 S 24th Ave Ste 10, Wausau, WI 54401-1705 | 2020-06-11 |
| 1841814035 | Vicki Shah | Dentist | 220 E Commerce Ct, Elkhorn, WI 53121-4371 | 2020-06-03 |
| 1790308666 | Michelle Zellmer | Dentist | 333 W Brown Deer Rd Ste A, Fox Point, WI 53217-2370 | 2020-05-26 |
| 1568083772 | Kolver Matos | Dentist | N112w16286 Mequon Rd, Germantown, WI 53022-3306 | 2020-04-28 |
| 1205466737 | Leyes Robers Dental LLC | Dentist | 3216 W County Rd Kk, Appleton, WI 54915 | 2020-01-23 |
| 1972133536 | Neha Solanki | Dentist | 1212 Horton St Ste 200, La Crosse, WI 54601-6289 | 2020-01-23 |
| 1023655131 | Pak Dental LLC | Dentist | 8241 S Howell Ave Ste 100, Oak Creek, WI 53154-8346 | 2019-12-09 |
| 1700428216 | Binninger Dentistry, LLC | Dentist | 12720 W North Ave Bldg B, Brookfield, WI 53005-4637 | 2019-10-16 |
| 1720629017 | Quirt Family Dentistry, S.c. | Dentist | W178n9379 Water Tower Pl, Menomonee Falls, WI 53051-8034 | 2019-10-08 |
| Find all providers with the same taxonomy | ||||
| City | SISTER BAY |
| Zip Code | 54234 |
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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.