RENNER AND MARTIN DDS SC (NPI# 1063634228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063634228 |
Entity Type | Organization |
Organization Name | RENNER AND MARTIN DDS SC |
Practice Address |
1111 Delafield St. #319 Waukesha WI 53188-3407 |
Mailing Address |
903 Lynne Court Waukesha WI 53186-3407 |
Practice Telephone | 2625493640 |
Mailing Telephone | 2625478780 |
Enumeration Date | 2007-05-03 |
Last Update Date | 2020-08-22 |
Authorized Official Name | DR. WILLIAM ROBERT RENNER (OWNER) |
Authorized Official Telephone | 2625493640 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
5002149-015 | WI | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | BADGERCARE | 33399400 | 01 |
Street Address |
1111 DELAFIELD ST. #319 |
City | WAUKESHA |
State | WI |
Zip Code | 53188-3407 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336787126 | Nicole Lee Berg-johnson | Nurse Practitioner | 820 Crestwood Dr., Waukesha, WI 53188 | 2019-12-12 |
1013475706 | Rachel Mueller | Occupational Therapist | 29667 Summit Ave, S11, Waukesha, WI 53188 | 2019-03-12 |
1861962649 | Emily Elizabeth Seefeld | Occupational Therapy Assistant | 29667 Summit Ave S11, Waukesha, WI 53188 | 2018-12-05 |
1003393307 | Ashley Susan Callahan | Dental Hygienist | 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 | 2018-07-19 |
1245741321 | Melissa Weir | Case Manager/Care Coordinator | 514 Riverview Avenue, Waukesha, WI 53188 | 2017-10-17 |
1093233629 | Patricia Marie Sombrio | Dental Hygienist | 711 Moreland Blvd 204, Waukesha, WI 53188 | 2017-09-04 |
1134660244 | Bdg of Wisconsin, Inc. | Behavioral Analyst | N19w2309 Riverwood Drive, Suite 350 Pmb 314, Waukesha, WI 53188 | 2017-03-09 |
1255888731 | Lynne Sarah Alva | Dental Hygienist | 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 | 2016-09-01 |
1881069730 | Michelle Koch | Occupational Therapist | 29667 Summit Ave. S11, Waukesha, WI 53188 | 2015-12-03 |
1952711012 | Rhonda Schroeder | Dental Hygienist | W286 N991 Shepherds Way, Waukesha, WI 53188 | 2014-04-29 |
Find all providers in zip 53188 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801400338 | Tanty Family Dental | Clinic/Center | W249s3642 Center Rd, Waukesha, WI 53189-7364 | 2020-09-02 |
1144764978 | Summit Square Dental LLC | Clinic/Center | 3228 Turnberry Oak Dr, Waukesha, WI 53188-3969 | 2016-12-13 |
1659749778 | Hillcrest Family Dental LLC | Clinic/Center | 1751 E Main St, Waukesha, WI 53186-3940 | 2015-09-05 |
1316347826 | Smiles for Miles Family Dentistry, LLC | Clinic/Center | S22w22660 Broadway, Suite 2, Waukesha, WI 53186-8100 | 2014-09-03 |
1477952687 | Proven Dental LLC | Clinic/Center | 1700 Coral Dr, Waukesha, WI 53186-1483 | 2014-08-14 |
1417295163 | Stephanie Race D.d.s., S.c. | Clinic/Center | W247s3114 Prairie Ave, Waukesha, WI 53189-7321 | 2013-01-30 |
1841538139 | Sunset Dental Care, S.c. | Clinic/Center | W247s3114 Prairie Ave, Waukesha, WI 53189-7321 | 2013-01-22 |
1245578665 | Jeffrey O'brien, D.d.s., S.c. | Clinic/Center | W247s3114 Prairie Ave, Waukesha, WI 53189-7321 | 2013-01-18 |
1114282829 | Your Family Dentist, LLC | Clinic/Center | 411 N Grand Ave, Suite 103, Waukesha, WI 53186-4961 | 2012-07-09 |
1629241237 | Waukesha County Community Dental Clinic, Inc. | Clinic/Center | 210 Nw Barstow St, Suite 305, Waukesha, WI 53188-3771 | 2008-04-04 |
Find all providers in WAUKESHA |
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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.