THE KIDS DENTIST LLC (NPI# 1407257108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407257108 |
| Entity Type | Organization |
| Organization Name | THE KIDS DENTIST LLC |
| Practice Address |
10618 N Port Washington Rd Mequon WI 53092-5013 |
| Practice Telephone | 2622410400 |
| Mailing Telephone | 2622410400 |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2014-09-12 |
| Authorized Official Name | DR. SHANE FISHER (OWNER) |
| Authorized Official Telephone | 2622410400 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
5127-015 | WI | Dental Providers |
| Street Address |
10618 N PORT WASHINGTON RD |
| City | MEQUON |
| State | WI |
| Zip Code | 53092-5013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942790761 | Kathryn Mueller | Specialist/Technologist | 117 Linden Lane, Apt 7, Thiensville, WI 53092 | 2018-05-17 |
| 1427547082 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 10996 N Port Washington Rd, Mequon, WI 53092 | 2018-05-08 |
| 1912437252 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | 11430 Port Washington Road, Mequon, WI 53092 | 2017-06-19 |
| 1629437256 | Sean S Tsang | Acupuncturist | 909 W. Mequon Rd., Mequon, WI 53092 | 2016-02-10 |
| 1497128433 | Nancy Snoots | Counselor | 4430 W Tarrytown Ln, Mequon, WI 53092 | 2015-11-12 |
| 1609265214 | Evan Guettel | Physical Therapist | 11363 N. Port Washington Road, Mequon, WI 53092 | 2015-01-20 |
| 1881091148 | Sarah Krueger | Counselor | 216 N Green Bay Rd Suite 108, Thiensville, WI 53092 | 2014-12-01 |
| 1245667088 | Lora Transportation, LLC | Non-emergency Medical Transport (VAN) | 1228 West Baldwin Crt., Mequon, WI 53092 | 2013-10-10 |
| 1710314000 | Roxxi M Davis | Social Worker | 7113 Tamarack Ct, Mequon, WI 53092 | 2013-10-01 |
| 1225473713 | Forefront Dermatology, S.c. | Dermatology | 10303 N Port Washington Rd Ste 101, Mequon, WI 53092 | 2013-05-09 |
| Find all providers in zip 53092 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508478454 | New Richmond Kidds Pediatric Dentistry LLC | Dentist | 1244 N 4th St Ste 300, New Richmond, WI 54017-7540 | 2020-08-21 |
| 1710509484 | Hospital Dentistry for Kids Inc. | Dentist | 4980 S County Rd T, Denmark, WI 54208 | 2020-05-15 |
| 1467808592 | Alexis Colosimo | Dentist | 11035 W Forest Home Ave Ste 116, Hales Corners, WI 53130-2541 | 2016-05-07 |
| 1649676032 | Matina Angelopoulou | Dentist | 1801 West Winsconsin Ave, Milwaukee, WI 53233 | 2014-11-12 |
| 1144631698 | Jennifer Sinnen | Dentist | 14430 W Greenfield Ave, Brookfield, WI 53005-7036 | 2014-05-17 |
| 1346667045 | David Howard Jadin | Dentist | 1245 Main St, Green Bay, WI 54302 | 2014-03-20 |
| 1396184370 | Adam Joseph Pamer | Dentist | 1320 S Green Bay Rd, Mt Pleasant, WI 53406-4406 | 2013-06-23 |
| 1255628491 | Ronald J Pruhs | Dentist | 4120 S Lake Dr, Apt. 251, Saint Francis, WI 53235-5954 | 2011-07-08 |
| 1982906525 | Jennifer Chun | Dentist | 100 River Pl Ste 110, Monona, WI 53716 | 2010-12-02 |
| 1043452758 | Barbara Lynn Phillips | Dentist | 8815 County Rd J, Woodruff, WI 54568-9636 | 2009-03-26 |
| 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.