RANDOLPH FAMILY DENTAL LLC (NPI# 1154711190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154711190 |
| Entity Type | Organization |
| Organization Name | RANDOLPH FAMILY DENTAL LLC |
| Practice Address |
125 N High St Randolph WI 53956-1267 |
| Practice Telephone | 9203263191 |
| Mailing Telephone | 9203263191 |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2015-01-29 |
| Authorized Official Name | DR. ROSS D WERNER (MEMBER) |
| Authorized Official Telephone | 9203263191 |
| 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 |
3858 | WI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | INDIVIDUAL NPI | 1801955950 | 01 |
| Street Address |
125 N HIGH ST |
| City | RANDOLPH |
| State | WI |
| Zip Code | 53956-1267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801955950 | Ross D Werner | Dentist | 125 N High St, Randolph, WI 53956-1267 | 2006-12-06 |
| 1457961971 | Myriel Jamae Werner | Dentist | 125 N High St, Randolph, WI 53956-1267 | 2020-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194778324 | Shannon N Sandstrom | Nurse Practitioner | 137 Cambria St, Randolph, WI 53956 | 2006-05-18 |
| 1336102169 | Melissa Elaine Lucarelli | Family Medicine | 504 S High Street, Randolph, WI 53956 | 2006-04-11 |
| 1811039761 | Consultants Laboratory of Wi, LLC | Clinical Medical Laboratory | 137 Cambria St, Randolph, WI 53956 | 2007-02-13 |
| 1497832257 | Randolph Community Clinic Sc | Family Medicine | 504 S High Street, Randolph, WI 53956 | 2006-11-01 |
| 1770529828 | Agnesian Healthcare | Durable Medical Equipment & Medical Supplies | 137 Cambria St, Randolph, WI 53956 | 2006-06-20 |
| 1962052548 | Tessa Lindner | Physical Therapist | 502 N High St, Randolph, WI 53956-1117 | 2019-09-16 |
| 1245646645 | Rebecca Yelle | Occupational Therapist | 509 Williams St, Randolph, WI 53956-1122 | 2014-07-07 |
| 1003959529 | James Leslie Jones | Chiropractor | 175 Stark St, Randolph, WI 53956-1243 | 2007-02-14 |
| 1356383822 | Md Group II LLC | Durable Medical Equipment & Medical Supplies | 107 N High St, Randolph, WI 53956-1267 | 2006-06-11 |
| 1326333006 | Michelle Dreger | Pharmacist | 107 N High St, Randolph, WI 53956-1267 | 2011-06-10 |
| Find all providers in zip 53956 | ||||
| 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 |
|---|---|---|---|---|
| 1972055861 | Yuhui Hu Dds LLC | Dentist | 140 State Route 10, Randolph, NJ 07869-1542 | 2016-10-26 |
| 1104271121 | Dr Parnass General Dentistry LLC | Dentist | 140 Route 10 W, Randolph, NJ 07869-1542 | 2016-04-27 |
| 1437519063 | Mawna Dhamotharan Kumar | Dentist | 8305, Wynbrook Drive, Randolph, NJ 07869-1297 | 2016-02-24 |
| 1588991780 | Michael Bravman | Dentist | 111 Everdale Rd, Randolph, NJ 07869-2301 | 2009-11-09 |
| 1336315837 | Family First Dental Associates of Wausa PC | Dentist | 105 Broadway, Randolph, NE 68771 | 2008-05-05 |
| 1730394354 | Young Kyu Kim | Dentist | 924 Route 10 West, Randolph, NJ 07869 | 2007-05-14 |
| 1265556062 | Mark Parnass | Dentist | 140 Route 10 West, K-mart Plaza, Randolph, NJ 07869 | 2007-03-19 |
| 1154445955 | Dr. Parnass Family Dentistry, LLC | Dentist | 140 Route10 West, K-mart Plaza, Randolph, NJ 07869 | 2007-03-19 |
| 1336278100 | Laura Castro | Dentist | 924 Route 10 W, Charmoy Dental, Randolph, NJ 07869-1932 | 2007-03-05 |
| 1104972181 | Richard Loguercio Dds PC | Dentist | 56 So Main St, Randolph, MA 02368 | 2007-01-25 |
| Find all providers in RANDOLPH | ||||
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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.