CENTRAL WISCONSIN ENDODONTIC SPECIALISTS LLC (NPI# 1164031464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164031464 |
| Entity Type | Organization |
| Organization Name | CENTRAL WISCONSIN ENDODONTIC SPECIALISTS LLC |
| Practice Address |
2606 Stewart Avenue #102 Wausau WI 54401 |
| Practice Telephone | 7158425691 |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-07-23 |
| Authorized Official Name | MITCH WEILAND (SENIOR ACCOUNTANT) |
| Authorized Official Telephone | 6083430818 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| MPC Endodontics | Doing Business As Name - Organization |
| Street Address |
2606 STEWART AVENUE #102 |
| City | WAUSAU |
| State | WI |
| Zip Code | 54401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1336701895 | Amy Kluetz | Counselor | 3000 Westhill Drive, Suite 100, Wausau, WI 54401 | 2019-07-05 |
| 1437640877 | Joseph T Fitz | Student in an Organized Health Care Education/Training Program | Aspirus Wausau Family Medicine, 425 Wind Ridge Drive, Wausau, WI 54401 | 2018-05-22 |
| 1699293241 | Amanda Nedd | Dietitian, Registered | 425 Pine Ridge Boulevard Suite 220 C, Wausau, WI 54401 | 2017-09-05 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1013389618 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 2727 Plaza Dr., Wausau, WI 54401 | 2015-10-22 |
| 1881091163 | Judy Lao | Dental Hygienist | 413 North 17th Avenue, Wausau, WI 54401 | 2014-12-02 |
| 1295012011 | Allison Waraksa | Pharmacist | 504 S. 17th Ave, Wausau, WI 54401 | 2011-11-08 |
| 1881974053 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 504 S 17th Ave, Wausau, WI 54401 | 2011-08-19 |
| 1528350436 | Craig R Kelman | Neurological Surgery | 425 Pine Ridge Blvd Ste 300, Wausau, WI 54401 | 2011-05-11 |
| Find all providers in zip 54401 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215344478 | Helen Tsao | Dentist | 2606 Stewart Ave, Ste 102, Wausau, WI 54401-5502 | 2014-07-18 |
| 1932322427 | Michael Miles | Dentist | 2620 Stewart Ave, Suite 212, Wausau, WI 54401-4170 | 2007-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891319273 | Janesville Endodontics | Dentist | 1616 N Randall Ave Ste 180, Janesville, WI 53545-1155 | 2020-06-02 |
| 1306480918 | Teng Kai Ong | Dentist | 1801 West Wisconsin Ave., Milwaukee, WI 53233 | 2019-11-06 |
| 1275973166 | Meridian Endodontics and Periodontics | Dentist | 20350 Water Tower Blvd Ste 203, Brookfield, WI 53045-3558 | 2013-06-25 |
| 1447698451 | Eva C Dahl | Dentist | 2700 National Dr Ste 1, Onalaska, WI 54650-6708 | 2013-06-12 |
| 1275873374 | F Kris Olsen | Dentist | 1320 S Green Bay Road, Racine Dental Group, Racine, WI 53406 | 2013-02-26 |
| 1063710655 | Erik Daniel Deyoung | Dentist | 6100 W State St, Apt. 636, Wauwatosa, WI 53213-2983 | 2011-03-05 |
| 1376786285 | Ronald David Meyers | Dentist | 2600 N Mayfair Rd Ste 240, Wauwatosa, WI 53226-1309 | 2009-04-08 |
| 1942450457 | Wisconsin Endodontic Group, S.c. | Dentist | 2600 N. Mayfair Rd., Ste 240, Wauwatosa, WI 53226 | 2008-09-22 |
| 1558519058 | Kendra Kay Boda | Dentist | 3004 Golf Rd Ste 102, Eau Claire, WI 54701-8794 | 2008-09-09 |
| 1083870232 | Daniel Young | Dentist | 2700 National Dr Ste 102, Onalaska, WI 54650-6709 | 2008-08-06 |
| Find all providers with the same taxonomy | ||||
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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.