FAMILY DENTAL OF SOUTH SHEBOYGAN (NPI# 1477993673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477993673 |
| Entity Type | Organization |
| Organization Name | FAMILY DENTAL OF SOUTH SHEBOYGAN |
| Practice Address |
3555 Washington Ave Sheboygan WI 53081 |
| Practice Telephone | 9203954819 |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2013-07-02 |
| Authorized Official Name | LINDSAY BEARDEN (CREDENTIALING) |
| Authorized Official Telephone | 2175405100 |
| Is Organization Subpart | Y |
| Parent Organization Name | QUIRT FAMILY DENTISTRY, SC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
3555 WASHINGTON AVE |
| City | SHEBOYGAN |
| State | WI |
| Zip Code | 53081 |
| 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 | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942652185 | Jacob Steven Son | Dentist | 3555 Wasington Ave., Sheboygan, WI 53081 | 2016-07-12 |
| 1831328293 | Kurtis S Kellner | Dentist | 4008 Enterprise Dr, Sheboygan, WI 53083-2245 | 2009-07-07 |
| 1629265350 | David P Mayer | Dentist | 2705 N 8th Street, Sheboygan, WI 53083 | 2007-09-26 |
| 1184844821 | Timothy Walter Kaufmann | Dentist | 2819 N 8th St, Sheboygan, WI 53083-4118 | 2007-04-26 |
| 1134248628 | Daniel Albert Humiston | Dentist | 1337 N Taylor Dr, Sheboygan, WI 53081-3012 | 2007-03-28 |
| 1184753519 | Robert Patrick Darling | Dentist | 638 Riverfront Dr, Suite G40, Sheboygan, WI 53081-4629 | 2007-03-02 |
| 1821149493 | Dean Delasanta | Dentist | 1431 N 8th St, Sheboygan, WI 53081-3441 | 2007-01-12 |
| 1306900550 | Rhonda Louise Sleiter | Dentist | 3233 Superior Ave, Sheboygan, WI 53081-1858 | 2006-12-21 |
| 1639258577 | Peter J Steinert | Dentist | 1214 S 23rd St, Sheboygan, WI 53081-5012 | 2006-11-02 |
| 1750468054 | Bruce A. Feider | Dentist | 2926 S 12th St, Sheboygan, WI 53081-6706 | 2006-11-01 |
| Find all providers in SHEBOYGAN | ||||
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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.