DR. BLAKE J EDINGER (NPI# 1750376968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750376968 |
| Entity Type | Individual |
| Full Name | DR. BLAKE J EDINGER |
| Credential | D.D.S. |
| Practice Address |
15397 State Highway 32 Lakewood WI 54138 |
| Mailing Address |
15954 Rivers Edge Dr Ste 304 Hayward WI 54843-7894 |
| Practice Telephone | 7152766321 |
| Mailing Telephone | 7156342541 |
| Mailing Fax Number | 7156342541 |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2018-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 3874 | WI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100065650 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Unit 3690, Apo, AE 091263690 | 3154528232 |
| Street Address |
15397 STATE HIGHWAY 32 |
| City | LAKEWOOD |
| State | WI |
| Zip Code | 54138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699778233 | The Lakes Community Health Center, Inc | Clinic/Center | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2005-05-27 |
| 1346892312 | Samantha Ann Debroux | Nurse Practitioner | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2019-07-10 |
| 1508347808 | Tammy J Whitt-sylfest | Dental Hygienist | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2018-08-24 |
| 1104297571 | Mackenzie Deaton | Dental Hygienist | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2015-10-12 |
| 1720455496 | Rene A Farah | Dental Hygienist | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2015-08-28 |
| 1386984078 | Stacie M Kramer | Dental Hygienist | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2013-02-18 |
| 1336417542 | Lori Lee Nelson | Dental Hygienist | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2011-12-02 |
| 1720369119 | Ashlei Elaine Mctrusty | Dental Hygienist | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2011-08-30 |
| 1053608992 | Peggy S Christianson | Nurse Practitioner | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2011-06-29 |
| 1174828024 | Gisela Gunderson | Dental Hygienist | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2011-01-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174830244 | Adam Robert Habeck | Chiropractor | 15267 State Hwy. 32, Lakewood, WI 54138 | 2010-09-09 |
| 1386708378 | Stacey Lee Bisenius | Dental Hygienist | 15397 State Hwy 32, Lakewood, WI 54138 | 2006-12-21 |
| 1801135371 | Habeck Chiropractic Center, LLC | Chiropractor | 15267 State Hwy. 32, Lakewood, WI 54138 | 2013-02-04 |
| 1023338506 | Orthopedic & Spine Therapy of Lakewood, Sc | Physical Therapist | 17187 Twin Pines Rd, Lakewood, WI 54138-9300 | 2010-06-07 |
| 1790162899 | Assure Family Practice LLC | Clinic/Center | 17187 Twin Pines Rd, Suite A, Lakewood, WI 54138-9300 | 2015-04-28 |
| 1265841944 | Sara Piontek | Massage Therapist | 17187 Twin Pines Rd, Lakewood, WI 54138-9300 | 2014-08-07 |
| 1588975908 | Orthopedic & Spine Therapy of Lakewood, Sc | Durable Medical Equipment & Medical Supplies | 17187 Twin Pines Rd, Lakewood, WI 54138-9300 | 2010-06-30 |
| 1235458894 | Lakewood Assisted Living, LLC | Assisted Living Facility | 17185 Flynn Ln, Lakewood, WI 54138-9593 | 2010-05-21 |
| 1740272848 | Jason William Nobles | Chiropractor | 15481 Commercial Rd, Ste G, Lakewood, WI 54138-9677 | 2005-08-16 |
| 1790284438 | Oconto Hospital & Medical Center Inc | Family Medicine | 15481 Commercial Rd, Lakewood, WI 54138-9677 | 2018-02-08 |
| Find all providers in zip 54138 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760025894 | Lakewood Dental Associates, LLC | Dentist | 838 River Ave Ste 1, Lakewood, NJ 08701-5279 | 2019-10-22 |
| 1851933287 | Jeri A. Logan | Dentist | 8064 W Jewell Ave Unit 100, Lakewood, CO 80232-6710 | 2019-10-17 |
| 1457838294 | Narges Lotfizadeh Dehkordi | Dentist | 5605 Lakewood Towne Center Blvd Sw Ste B, Lakewood, WA 98499-3855 | 2018-07-24 |
| 1770069239 | Jeffrey A. Osborn | Dentist | 8520 Steilacoom Blvd Sw Ste 202, Lakewood, WA 98498-4773 | 2018-07-17 |
| 1790279743 | Andrew Montalvo | Dentist | 12375 W Auburn Dr, Lakewood, CO 80228-4747 | 2018-06-21 |
| 1508376906 | Green Gables Dental LLC | Dentist | 7586 W Jewell Ave # 2-303, Lakewood, CO 80232-6890 | 2017-10-11 |
| 1073964284 | Travis Jay Barr | Dentist | 3333 S Wadsworth Blvd Unit D305, Lakewood, CO 80227-5142 | 2016-06-29 |
| 1285094672 | Danijela Jankovic | Dentist | 7611 W.colfax Avenue, Suite D, Lakewood, CO 80214 | 2016-02-29 |
| 1831556117 | John Kim | Dentist | 10011 Bridgeport Way Sw, Ste 700, Lakewood, WA 98499-2332 | 2016-01-18 |
| 1811361751 | Simple Smiles, Pllc | Dentist | 225 S Sheridan Blvd Ste 114, Lakewood, CO 80226-2405 | 2015-11-16 |
| Find all providers in LAKEWOOD | ||||
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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.