DR. LIBERTY ANN BOUCHER (NPI# 1114183126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114183126 |
| Entity Type | Individual |
| Full Name | DR. LIBERTY ANN BOUCHER |
| Credential | DDS |
| Practice Address |
7040 N Port Washington Rd Glendale WI 53217-3838 |
| Mailing Address |
4037 N Downer Ave Shorewood WI 53211-2127 |
| Practice Telephone | 4143516010 |
| Mailing Telephone | 4144182280 |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6297-15 | WI | Dental Providers |
| Street Address |
7040 N PORT WASHINGTON RD |
| City | GLENDALE |
| State | WI |
| Zip Code | 53217-3838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821047283 | James Edward Berman | Dermatology | 7040 N Port Washington Rd, Suite 404, Glendale, WI 53217-3885 | 2006-05-10 |
| 1245506971 | Forefront Dermatology, S.c. | Dermatology | 7040 N Port Washington Rd, Suite 404, Glendale, WI 53217 | 2012-03-27 |
| 1891068599 | Petrou-haefs Eyecare, LLC | Clinic/Center | 7040 N Port Washington Rd, Suite 420, Glendale, WI 53217-3885 | 2012-02-12 |
| 1427234723 | Joseph L Gaffney | Dentist | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2008-01-16 |
| 1972710077 | Daniel C Ross | Student in an Organized Health Care Education/Training Program | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2007-05-17 |
| 1265562631 | Wisconsin Dental Group,s.c. | Dentist | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2007-03-06 |
| 1003946252 | Wisconsin Dental Group, S.c. | Dentist | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2007-03-06 |
| 1346380979 | James Lipinski | Dentist | 7040 N Port Washington Rd, Ste 414, Glendale, WI 53217-3838 | 2007-02-06 |
| 1508936154 | Northeast Obgyn Sc | Obstetrics & Gynecology | 7040 N Port Washington Rd, Suite 400, Glendale, WI 53217-3838 | 2006-11-09 |
| 1942380522 | Stephanie Ann Murphy | Dentist | 7040 N Port Washington Rd, 410, Glendale, WI 53217-3838 | 2006-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632587 | Jasmine Dockery | Pharmacist | 5400 N Port Washington, Glendale, WI 53217 | 2020-02-23 |
| 1174017339 | North Lakes Nursing Home Health Care Agency LLC | Home Health | 225 E Fairmount Ave, Milwaukee, WI 53217 | 2018-06-20 |
| 1083140289 | Miriah Ann King, Ms, Lpc | Counselor | 7805 North Boyd Way, Fox Point, WI 53217 | 2017-05-08 |
| 1245783067 | Lakesha L Jones | Counselor | 5235 N Ironwood Rd, Glendale, WI 53217 | 2016-07-28 |
| 1750783312 | Ibrahim S Abouzeid | Specialist/Technologist, Other | 333 W Brown Deer Road, #240, Milwaukee, WI 53217 | 2014-09-25 |
| 1255733598 | Victoria Gorodetsky | Pharmacist | 229 W Indian Creek Ct, Milwaukee, WI 53217 | 2014-09-18 |
| 1174800049 | John Herman Esser | Internal Medicine | 1050 W Acacia Rd, Milwaukee, WI 53217 | 2011-11-07 |
| 1710298351 | Leann M Harman | Physical Therapist | 5333 N Port Washington Rd Ste B, Glendale, WI 53217 | 2010-06-29 |
| 1306012455 | Emily Marie Gallagher | Speech-Language Pathologist | 6700 N. Port Washington Road, Milwaukee, WI 53217 | 2008-05-07 |
| 1164625455 | Mary Catherine Enderlin | Psychologist | 6110 N Port Washington Road, The Cambridge Group, Glendale, WI 53217 | 2007-06-06 |
| Find all providers in zip 53217 | ||||
| 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 |
|---|---|---|---|---|
| 1427660422 | Joson Dental Corporation | Dentist | 1415 E Colorado St Ste C, Glendale, CA 91205-1577 | 2020-08-20 |
| 1558987271 | Edward Kelly Furlong | Dentist | 5400 W Northern Ave Ste 202, Glendale, AZ 85301-1591 | 2020-06-18 |
| 1578116380 | Krina Patel Mesuria | Dentist | 4545 W Beardsley Rd Apt 2083, Glendale, AZ 85308-5080 | 2019-07-20 |
| 1801455068 | Clayton Corbridge | Dentist | 20100 N 51st Ave Ste E550, Glendale, AZ 85308-5089 | 2019-06-11 |
| 1811454481 | Lucio H Kim Dds | Dentist | 620 E Glenoaks Blvd Ste A, Glendale, CA 91207-1769 | 2019-03-01 |
| 1902386634 | Arjun Bassin | Dentist | 7025 N 75th Ave Ste 101, Glendale, AZ 85303-2545 | 2018-08-21 |
| 1194216200 | Brandon Dawson | Dentist | 9455 W Glendale Ave, Glendale, AZ 85305 | 2018-05-24 |
| 1578062121 | Missagh Pezeshkian, D.d. S., A Professional Corporation | Dentist | 1016 E Broadway Ste 104, Glendale, CA 91205-4534 | 2018-02-09 |
| 1073037347 | Ian Phillip Bishop | Dentist | 6249 W Kristal Way, Glendale, AZ 85308-7661 | 2017-07-28 |
| 1801317391 | Christine Tran | Dentist | 18275 N 59th Ave Ste 128, Glendale, AZ 85308-1252 | 2017-07-05 |
| Find all providers in GLENDALE | ||||
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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.