PREMIER PERIODONTICS LLC (NPI# 1770911976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770911976 |
| Entity Type | Organization |
| Organization Name | PREMIER PERIODONTICS LLC |
| Practice Address |
2933 W Layton Ave Greenfield WI 53221-2626 |
| Practice Telephone | 4142822642 |
| Practice Fax Number | 4142821952 |
| Mailing Telephone | 4142822642 |
| Mailing Fax Number | 4142821952 |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2013-10-24 |
| Authorized Official Name | GENEVIEVE E POPPE (PARTNER) |
| Authorized Official Telephone | 6083583370 |
| Is Organization Subpart | Y |
| Parent Organization Name | STEPPING STONE DENTAL PARTNERS LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0300X |
Dentist Specialization: Periodontics |
7160-15 | WI | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
5001847-15 | WI | Dental Providers |
| Street Address |
2933 W LAYTON AVE |
| City | GREENFIELD |
| State | WI |
| Zip Code | 53221-2626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235132192 | Constantine Stamatelakys | Dentist | 2933 W Layton Ave, Greenfield, WI 53221-2626 | 2005-05-24 |
| 1265743488 | Eddie Morales | Dentist | 2933 W Layton Ave, Greenfield, WI 53221-2626 | 2010-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487205944 | Hayat Pharmacy 20 LLC | Pharmacy | 805 W. Layton Ave., Suite B, Milwaukee, WI 53221 | 2019-09-26 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1407343965 | Informe Healthcare LLC | Counselor | 2741 W Layton Ave., Suite 106, Milwaukee, WI 53221 | 2018-04-19 |
| 1447781992 | Itamar Yaakov Gnatt | Emergency Medicine | 2900 W Oklahoma Ave, St Lukes Medical Center, Milwaukee, WI 53221 | 2017-03-27 |
| 1194277160 | Suzanne Derosier | Licensed Practical Nurse | 3910 W Bridge, Greenfield, WI 53221 | 2016-10-26 |
| 1265988117 | Obi Home Care | Clinic/Center | 4439 S 20th St, Milwaukee, WI 53221 | 2016-08-31 |
| 1427430602 | Zezenya Health Care S.c. | Pain Medicine | 5114 S 27th St # 763, Milwaukee, WI 53221 | 2015-06-24 |
| 1851771091 | Feisal J Salahadyn | Counselor | 4800 South 10th Street, Milwaukee, WI 53221 | 2015-06-03 |
| 1114312386 | Holistic Home Health Care Incorporated | Adult Companion | 3422 West Howard Ave, Greenfield, WI 53221 | 2015-04-03 |
| 1841698834 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 5220 S 27th St., Milwaukee, WI 53221 | 2014-12-08 |
| Find all providers in zip 53221 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821318361 | Jonell K. Hopeck, Dds, PC | Dentist | 33 Riddell St Ste 6, Greenfield, MA 01301-2026 | 2010-06-07 |
| 1558436121 | Steven Henry Goldsher | Dentist | 289 High Street, Greenfield, MA 01301 | 2006-11-21 |
| 1235132192 | Constantine Stamatelakys | Dentist | 2933 W Layton Ave, Greenfield, WI 53221-2626 | 2005-05-24 |
| 1013482298 | Dental Specialists of Milwaukee LLC | Dentist | 8405 W Forest Home Ave, Greenfield, WI 53228-3407 | 2018-10-03 |
| 1053766501 | Greenfield Periodontics LLC | Dentist | 120 W Mckenzie Rd, Ste J, Greenfield, IN 46140-1072 | 2016-05-03 |
| 1265743488 | Eddie Morales | Dentist | 2933 W Layton Ave, Greenfield, WI 53221-2626 | 2010-06-23 |
| 1386830883 | Frederick D. Mesloh PC | Dentist | 33 Riddell St, Greenfield, MA 01301-2025 | 2007-09-18 |
| 1962553834 | Progressive Periodonitics and Dental Implants | Dentist | 8405 W Forest Home Ave, Suite 203, Greenfield, WI 53228-3407 | 2007-01-16 |
| 1841303278 | Steven A Geller | Dentist | 33 Riddell St, Greenfield, MA 01301-2025 | 2006-08-17 |
| 1598773764 | Timothy J Mcnamara | Dentist | 8405 W Forest Home Ave, Suite 203, Greenfield, WI 53228-3407 | 2006-08-04 |
| Find all providers in GREENFIELD | ||||
| City | GREENFIELD |
| Zip Code | 53221 |
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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.