SHORELINE PERIODONTICS LIMITED (NPI# 1376789933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376789933 |
Entity Type | Organization |
Organization Name | SHORELINE PERIODONTICS LIMITED |
Practice Address |
2808 Kohler Memorial Dr Suite 2 Sheboygan WI 53081-3177 |
Practice Telephone | 9204528802 |
Practice Fax Number | 9204522852 |
Mailing Telephone | 9204528802 |
Mailing Fax Number | 9204522852 |
Enumeration Date | 2008-12-31 |
Last Update Date | 2008-12-31 |
Authorized Official Name | DR. HENRY WILLIAM HOGE (OWNER) |
Authorized Official Telephone | 9204528802 |
Authorized Official Credential | DDS MS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
Street Address |
2808 KOHLER MEMORIAL DR SUITE 2 |
City | SHEBOYGAN |
State | WI |
Zip Code | 53081-3177 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083008684 | Laura Kocmoud | Social Worker | 2808 Kohler Memorial Dr, Sheboygan, WI 53081-3177 | 2015-03-23 |
1811385156 | Barbara J H Anderson Lmft Counseling Services LLC | Marriage & Family Therapist | 2808 Kohler Memorial Dr, Suite 8, Sheboygan, WI 53081-3177 | 2015-01-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770053696 | Kathy Hughes Counseling, LLC | Community/Behavioral Health | 630 Riverfront Dr Ste 203, Sheboygan, WI 53081 | 2018-12-04 |
1780159004 | Great Lakes Clinic and Consultants, LLC | Clinic/Center | 1407 North 8th Street, Suite 203, Sheboygan, WI 53081 | 2018-10-13 |
1174032106 | Laura Elizabeth Manning | Registered Nurse | 325 Linocln Ave, Sheboygan, WI 53081 | 2017-09-21 |
1043733686 | Chasidy D Wilke | Behavioral Analyst | 2223 Terrace View Dr Apt 3a, Sheboygan, WI 53081 | 2017-07-25 |
1700320074 | Darlene Wilken | Counselor | 2842 S. Business Dr, Sheboygan, WI 53081 | 2016-12-06 |
1942652185 | Jacob Steven Son | Dentist | 3555 Wasington Ave., Sheboygan, WI 53081 | 2016-07-12 |
1225491749 | Cassandra Lea Loehndorf | Social Worker | 3321 S. 12th St., Sheboygan, WI 53081 | 2016-04-01 |
1003201112 | Jason Meinhardt | Dentist | 2115 S Memorial Pl, Sheboygan, WI 53081 | 2015-04-06 |
1346634110 | Christopher Lenz | Specialist/Technologist | 2920 Superior Ave., Prevea Orthopedics, Sheboygan, WI 53081 | 2015-03-19 |
1780008060 | James Simac | Counselor | 503 Wisconsin Ave., Sheboygan, WI 53081 | 2014-02-07 |
Find all providers in zip 53081 |
Taxonomy Code | 1223P0300X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Periodontics |
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457496580 | Henry William Hoge | Dentist | 2808 Kohler Memorial Drive, Suite 2, Sheboygan, WI 53081-3177 | 2007-02-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235683830 | Phillip Crum | Dentist | 2581 Development Dr Ste 204, Bellevue, WI 54311-4248 | 2016-08-11 |
1285937557 | Craig William Byers | Dentist | 2457 North Mayfair Road, Suite 102, Wauwatosa, WI 53226-1405 | 2010-12-08 |
1558662387 | Jason William Cooke | Dentist | 2557b E Calumet St, Appleton, WI 54915-4748 | 2010-11-10 |
1780998997 | Thomas C. Kelley Dds Msd LLC | Dentist | 17280 W North Ave Ste 203, Brookfield, WI 53045-4366 | 2010-07-29 |
1003052895 | James P. Herman | Dentist | 5624 S Bonnie Ln, Hales Corners, WI 53130-1674 | 2008-12-28 |
1760684930 | Jeffrey Joseph Burke | Dentist | 2323 S 109th St Ste 275, West Allis, WI 53227-1912 | 2007-06-01 |
1992915276 | Scott George Metskas | Dentist | 3364 Iris Ln, Stevens Point, WI 54481-5618 | 2007-05-23 |
1134339500 | Fox River Periodontics Sc | Dentist | 2557b East Calumet St, Appleton, WI 54915 | 2007-05-23 |
1891903043 | Denise Y Shih | Dentist | 2853 N Marietta Ave, Milwaukee, WI 53211-3420 | 2007-05-20 |
1629280987 | Nancy Ellen Shumate | Dentist | 2600 N Mayfair Rd Ste 340, Wauwatosa, WI 53226-1372 | 2007-05-07 |
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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.