DEER CREEK DENTAL CLINIC, LTD (NPI# 1700110574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700110574 |
| Entity Type | Organization |
| Organization Name | DEER CREEK DENTAL CLINIC, LTD |
| Practice Address |
820 N Superior Ave Tomah WI 54660-1120 |
| Practice Telephone | 6083725000 |
| Mailing Telephone | 6083725000 |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2014-03-13 |
| Authorized Official Name | MRS. KATHERINE E KONZE (OFFICE ADMINISTRATOR) |
| Authorized Official Telephone | 6083725000 |
| Authorized Official Credential | PHR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
3857 | WI | Ambulatory Health Care Facilities |
| Street Address |
820 N SUPERIOR AVE |
| City | TOMAH |
| State | WI |
| Zip Code | 54660-1120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093813933 | Mark Stephen Mueller | Dentist | 820 N Superior Ave, Tomah, WI 54660-1120 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255786281 | Jean Hinrichsen | Nurse Practitioner | 500 E Veterans Administration, Tomah, WI 54660 | 2016-04-27 |
| 1871994418 | Jennifer Annette Aeling | Psychologist | 500 E Veterans Street, Mh Admin, Tomah, WI 54660 | 2014-09-15 |
| 1003182346 | James Arthur Hennes | Psychiatric Unit | 515 Veterans St., Tomah, WI 54660 | 2012-03-30 |
| 1619114931 | Saint-mark Enterprises 1798 LLC | Durable Medical Equipment & Medical Supplies | 300 Superior Avenue, Tomah, WI 54660 | 2009-01-08 |
| 1629259163 | Mark Frederick Mueller | Counselor | 324 Butts Avenue, Tomah, WI 54660 | 2007-11-26 |
| 1073713293 | Sheetal Reddy Marri | Psychiatry & Neurology | 5000 Veterans St., Tomah, WI 54660 | 2007-07-25 |
| 1528144946 | Kevin Albert Stagman | Optometrist | 222 West Mccoy Blvd, Tomah, WI 54660 | 2006-10-27 |
| 1346320058 | Eugenia S Durst | Nurse Practitioner | 500 East Veterans St, Tomah, WI 54660 | 2006-10-17 |
| 1962596536 | Angela Kay Fuller | Nurse Practitioner | 321 Butts Ave., Tomah Memorial Hospital, Tomah, WI 54660 | 2006-10-03 |
| 1285737767 | James John Blado | Dentist | 1116 Superior Ave, Superior Suites, Tomah, WI 54660 | 2006-09-07 |
| Find all providers in zip 54660 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| 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 | ||||
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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.