DR. JERRY LEE UTLEY (NPI# 1780803361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780803361 |
| Entity Type | Individual |
| Full Name | DR. JERRY LEE UTLEY |
| Credential | DDS |
| Practice Address |
1212 Horton St La Crosse WI 54601-6372 |
| Mailing Address |
401 Gillette St Apt 303 La Crosse WI 54603-4208 |
| Practice Telephone | 6087881090 |
| Mailing Telephone | 6084981965 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
D11374 | MN | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6072 | WI | Dental Providers |
| Street Address |
1212 HORTON ST |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54601-6372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174652283 | Kevin Scott King | Dentist | 1212 Horton St, La Crosse, WI 54601-6372 | 2007-03-05 |
| 1104436088 | Katherine Joan Wang | Dentist | 1212 Horton St, La Crosse, WI 54601-6372 | 2020-08-05 |
| 1518348416 | Connie Bao | Dentist | 1212 Horton St, La Crosse, WI 54601-6372 | 2015-06-16 |
| 1639462567 | James Edward Kertis | Dentist | 1212 Horton St, La Crosse, WI 54601-6372 | 2011-05-25 |
| 1649569161 | Joseph Uker | Dentist | 1212 Horton St, La Crosse, WI 54601-6372 | 2011-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324265 | Meagan Mcrae | Student in an Organized Health Care Education/Training Program | 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 | 2020-04-07 |
| 1255969671 | Erin Dingman | Student in an Organized Health Care Education/Training Program | 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-31 |
| 1619505047 | Nicole Kay Lynch | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 | 2020-03-31 |
| 1174151757 | Jenna Sells | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1740818301 | Katie Irene Tahtinen | Student in an Organized Health Care Education/Training Program | Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 | 2020-03-30 |
| 1932737517 | Margaret May Grimm | Student in an Organized Health Care Education/Training Program | Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1831727312 | Matthew Timothy Axler | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1093340473 | Denise Stinson | Technician | 1311 Badger St, Apt 505, La Crosse, WI 54601 | 2020-03-06 |
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1750913356 | Liza R Collins | Massage Therapist | 1415 State Wi 16, La Crosse, WI 54601 | 2020-02-11 |
| Find all providers in zip 54601 | ||||
| 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 |
|---|---|---|---|---|
| 1972133536 | Neha Solanki | Dentist | 1212 Horton St Ste 200, La Crosse, WI 54601-6289 | 2020-01-23 |
| 1528323102 | Michael David Gillins | Dentist | 201 3rd St N, La Crosse, WI 54601 | 2012-07-10 |
| 1114184041 | Fred Herbert Ross | Dentist | 537 North Losey Blvd, La Crosse, WI 54601 | 2008-05-19 |
| 1942322771 | Thomas Fleishman | Dentist | 1720 Jackson St # 100, La Crosse, WI 54601-6679 | 2007-04-04 |
| 1396866026 | Kevin B. Cook, D.d.s., S.c. | Dentist | 1800 State Road 16, La Crosse, WI 54601-3011 | 2007-04-02 |
| 1174652283 | Kevin Scott King | Dentist | 1212 Horton St, La Crosse, WI 54601-6372 | 2007-03-05 |
| 1649354655 | James Francis Kadlec | Dentist | 205 Fifth Ave So, Ste 508, La Crosse, WI 54601-4059 | 2006-10-25 |
| 1316030091 | Karen Dawn Spitzer | Dentist | 3143 State Road Suite 201, La Crosse, WI 54601 | 2006-10-02 |
| 1801906284 | Jeffrey M Sedlock | Dentist | 201 7th St S, La Crosse, WI 54601-4171 | 2006-08-30 |
| 1518989060 | John T Dingman | Dentist | 1025 King St, La Crosse, WI 54601-4119 | 2006-07-24 |
| Find all providers in LA CROSSE | ||||
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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.