RACINE TOOTH TOWN DENTISTRY FOR KIDS (NPI# 1427610179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427610179 |
| Entity Type | Organization |
| Organization Name | RACINE TOOTH TOWN DENTISTRY FOR KIDS |
| Practice Address |
3801 Washington Ave Racine WI 53405-2853 |
| Practice Telephone | 4149491938 |
| Mailing Telephone | 4149491938 |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |
| Authorized Official Name | NATHAN HENRY KNUTSEN (OWNING DENTIST) |
| Authorized Official Telephone | 4147970328 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
3801 WASHINGTON AVE |
| City | RACINE |
| State | WI |
| Zip Code | 53405-2853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497805964 | Robert Arnold Bissegger | Dentist | 3801 Washington Ave, Racine, WI 53405-2853 | 2007-01-10 |
| 1659936896 | Jordan Craig Reading | Dentist | 3801 Washington Ave, Racine, WI 53405-2853 | 2019-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609407923 | Anita Kathy Nykaza | Dietitian, Registered | 3805 A Suite 311, Racine, WI 53405 | 2020-01-27 |
| 1023666062 | Shawn L Drulia | Physician Assistant | 3805 Spring St #320, Racine, WI 53405 | 2019-09-03 |
| 1235627720 | Oxygen One, Inc. | Durable Medical Equipment & Medical Supplies | 3805a Spring Street, Suite 210, Racine, WI 53405 | 2018-04-30 |
| 1356838650 | Melissa Metzger | Psychologist | 2340 Mohr Ave, Racine, WI 53405 | 2018-04-23 |
| 1689029217 | Melissa Ileen Swainston | Nurse Practitioner | 3803 Spring St., Suite Number 410, Racine, WI 53405 | 2016-05-02 |
| 1215305487 | Denetta Lauraelaine Flowers | Licensed Practical Nurse | 4311 Durand Ave., #104, Mt.pleasant, WI 53405 | 2015-09-04 |
| 1841675204 | Colleen Koderca | Registered Nurse | 3317-meachem Rd, Racine, WI 53405 | 2015-07-28 |
| 1790102986 | Georges Wakim | Specialist/Technologist | 3811 Spring St., Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1982021176 | Matthew F Patzke | Specialist/Technologist | 3811 Spring Street Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1073930269 | Jessica Geisler | Specialist/Technologist | 3811 Spring Street Suite #102, Racine, WI 53405 | 2014-03-25 |
| Find all providers in zip 53405 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487264891 | Bright Dental Racine LLC | Clinic/Center | 2705 Douglas Ave, Racine, WI 53402-4113 | 2020-08-01 |
| 1457905861 | Wisconsin Smiles | Clinic/Center | 4915 Washington Ave Ste B, Racine, WI 53406-4249 | 2019-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063907 | Osceola Family Dental, Ltd | Clinic/Center | 215 N Cascade St, Osceola, WI 54020 | 2020-11-03 |
| 1578173985 | Bright Dental and Braces LLC | Clinic/Center | 3046 Fish Hatchery Rd, Fitchburg, WI 53713-3125 | 2020-08-01 |
| 1609493188 | Willow Dental Group LLC | Clinic/Center | 3333 S Sunnyslope Rd Ste 100, New Berlin, WI 53151-4504 | 2020-06-30 |
| 1447875711 | Iola Family Dental, LLC | Clinic/Center | 100 Pine Crest Ln, Iola, WI 54945-8230 | 2020-06-12 |
| 1073135331 | Oasis Dental LLC | Clinic/Center | 1037 S Cesar E Chavez Dr, Milwaukee, WI 53204-2204 | 2020-05-09 |
| 1679116685 | Mdc Milwaukee, LLC | Clinic/Center | 4701 W National Ave, Milwaukee, WI 53214-3521 | 2019-10-22 |
| 1982263893 | Schmidt Dental Holdings LLC | Clinic/Center | 7430 W Forest Home Ave, Greenfield, WI 53220-3358 | 2019-06-13 |
| 1124580352 | Upper Lakes Dental, LLC | Clinic/Center | 908 E Main St Ste C, Winneconne, WI 54986-9672 | 2019-04-05 |
| 1356808067 | Julia Fosterarmstrong | Clinic/Center | 335 Vernal Ave, Milton, WI 53563-1248 | 2019-02-28 |
| 1366907032 | Dr John M Kane Sc | Clinic/Center | 10317 N Greenwood Ln, Hayward, WI 54843-7167 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on RACINE TOOTH TOWN DENTISTRY FOR KIDS.
| 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.