LAKE GENEVA DENTAL CARE, LLC (NPI# 1326473927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326473927 |
| Entity Type | Organization |
| Organization Name | LAKE GENEVA DENTAL CARE, LLC |
| Other Organization Name | BELOIT DENTAL |
| Practice Address |
1454 E Huebbe Pkwy Beloit WI 53511-1714 |
| Mailing Address |
333 W 1st St Elmhurst IL 60126-2641 |
| Practice Telephone | 6083620672 |
| Practice Fax Number | 6083624960 |
| Mailing Telephone | 6308335110 |
| Mailing Fax Number | 6308330458 |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2013-09-13 |
| Authorized Official Name | DR. LAWRENCE GROH (OWNER/PRESIDENT) |
| Authorized Official Telephone | 6308335110 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
019014858 | IL | Dental Providers |
| Other Name | Type Code |
|---|---|
| Beloit Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235545419 | Lake Geneva Dental Care, LLC | Dentist | 311 Parkview Dr, Milton, WI 53563-1538 | 2014-07-08 |
| Street Address |
1454 E HUEBBE PKWY |
| City | BELOIT |
| State | WI |
| Zip Code | 53511-1714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730738485 | Linda Lee Cook | Technician | 914 Cranston Rd., Beloit, WI 53511 | 2019-09-05 |
| 1033773734 | Holistic Counseling Services, LLC | Counselor | 1517 Huebbe Parkway, Ste A, Beloit, WI 53511 | 2019-04-28 |
| 1578073870 | Bonita May Cooke | Counselor | 838 Grant St., Beloit, WI 53511 | 2017-10-02 |
| 1679091219 | Stacy Lynn Gallagher | Licensed Practical Nurse | 1060 Bittel St, Beloit, WI 53511 | 2017-09-04 |
| 1629448824 | Brenda Jean Allen | Registered Nurse | 2907 E. Leona Drive, Beloit, WI 53511 | 2015-09-30 |
| 1033595038 | Amber Noel Slaybaugh | Physical Therapist | 838 E. Azalea Ter., Beloit, WI 53511 | 2015-08-03 |
| 1407260326 | Quirt Family Dentistry, Sc | Dentist | 2777 Milwaukee Rd, Beloit, WI 53511 | 2014-06-18 |
| 1821436973 | Raymond K Spade | Counselor | 2240 Prairie Ave., Beloit, WI 53511 | 2013-06-11 |
| 1629321658 | Sarah Ann Nelson | Physical Therapist | 1905 W. Hart Road, Beloit, WI 53511 | 2012-10-15 |
| 1235494212 | Mary Ann Hudson | Nurse Practitioner | 700 College Street, Beloit College, Beloit, WI 53511 | 2012-07-06 |
| Find all providers in zip 53511 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427060003 | Bradford Victor Eneix | Dentist | 2359 Murphy Woods Road, Beloit, WI 53511 | 2006-08-12 |
| 1417952011 | Ronald L Guttu | Dentist | 2359 Murphy Woods Rd, Beloit, WI 53511-2343 | 2005-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720569783 | Greater Milwaukee Oral Surgery, L.L.C. | Dentist | 4811 S 76th St Ste 304, Greenfield, WI 53220-4350 | 2018-08-27 |
| 1124516893 | Baycare Clinic, LLP | Dentist | 636 N 12th Ave, Sturgeon Bay, WI 54235-1249 | 2018-04-27 |
| 1477065787 | Central Wisconsin Oral and Facial Surgery, LLC | Dentist | 438 Edison St, Antigo, WI 54409-1845 | 2017-10-26 |
| 1497266910 | Donald Ervin Linneman | Dentist | Center 4820 N Sherman Road, Winnebago Correction Center, Drug Abuse Correctional, Winnebago, WI 54985-0036 | 2017-10-24 |
| 1063869485 | Tyler Kalmuck | Dentist | 3637 Wilgus Ave, Sheboygan, WI 53081-3050 | 2016-05-16 |
| 1952717753 | Judson Charles Smith | Dentist | 2323 N Mayfair Rd Ste 102, Milwaukee, WI 53226 | 2014-07-01 |
| 1073930459 | Paul Pamula | Dentist | 1925 S Green Bay Rd, Mount Pleasant, WI 53406-4654 | 2014-03-24 |
| 1093154601 | Matthew D Reiland | Dentist | 2921 Landmark Pl Ste 100, Madison, WI 53713-4248 | 2013-06-17 |
| 1922364363 | Ell Louis Lee | Dentist | 2361 Lost Dauphin Rd, De Pere, WI 54115-9165 | 2012-04-10 |
| 1003100470 | Eddie Kiyoshi Brotkowski | Dentist | 464 S Hickory St Ste A, Fond Du Lac, WI 54935-5531 | 2011-06-02 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LAKE GENEVA DENTAL CARE, LLC.
| 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.