DENTURESMART DENTURE SERVICE LLC (NPI# 1417345307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417345307 |
| Entity Type | Organization |
| Organization Name | DENTURESMART DENTURE SERVICE LLC |
| Practice Address |
605 2nd Ave S Ste 130 Onalaska WI 54650-3388 |
| Mailing Address |
605 2nd Ave S Suite 130 Onalaska WI 54650-3388 |
| Practice Telephone | 6085193946 |
| Practice Fax Number | 6085193947 |
| Mailing Telephone | 6085193946 |
| Mailing Fax Number | 6085193947 |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2015-01-09 |
| Authorized Official Name | MR. SCOTT WILLIAM CORTOPASSI (OWNER) |
| Authorized Official Telephone | 6085193946 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | Dental Providers | ||
| Y | 126900000X | Dental Laboratory Technician | Dental Providers |
| Street Address |
605 2ND AVE S STE 130 |
| City | ONALASKA |
| State | WI |
| Zip Code | 54650-3388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568824027 | Kyle Quillin | Student in an Organized Health Care Education/Training Program | 236 Kevin Ct, Onalaska, WI 54650 | 2016-03-24 |
| 1831577881 | Katelyn Nicole Patten | Counselor | 575 Lester Ave, Onalaska, WI 54650 | 2015-05-11 |
| 1619369758 | Amelia Vruble | Registered Nurse | 1047 Terrace Drive, Onalaska, WI 54650 | 2015-02-26 |
| 1699186528 | C. Nathan Vannatta | Physical Therapist | 3111 Gunersen Dr, Onalaska, WI 54650 | 2014-05-13 |
| 1770867640 | Claire Sweet | Pharmacist | 9400 Hwy 16, Target T-0620, Onalaska, WI 54650 | 2011-10-10 |
| 1306140439 | Jared I Darveaux | Internal Medicine | 311 Gundersen Dr, Onalaska, WI 54650 | 2011-01-04 |
| 1326299488 | Demetrios Spyridon Theodoropoulos | Allergy & Immunology | 2727 Midwest Drive, Onalaska, WI 54650 | 2008-10-08 |
| 1114190618 | Nancy Ellen Reithel | Physical Therapist | 610 Westwood Drive, Onalaska, WI 54650 | 2008-04-07 |
| 1902972896 | Maplewood Dental | Dentist | 1202 County Trunk Ph, Suite 300, Onalaska, WI 54650 | 2006-11-24 |
| 1245309327 | Benjamin John Breidenbach | Chiropractor | 1640 George St, Lacrosse, WI 54650 | 2006-11-06 |
| Find all providers in zip 54650 | ||||
| Taxonomy Code | 126900000X |
| Grouping | Dental Providers |
| Classification | Dental Laboratory Technician |
| An individual who has the skill and knowledge in the fabrication of dental appliances, prostheses and devices in accordance with a dentist's laboratory work authorization. To avoid misleading the public, no occupational title other than dental laboratory technician or certified dental technician (when appropriate) should be used to describe this auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
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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.