DR. ANDREW R LULLOFF (NPI# 1881608974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881608974 |
| Entity Type | Individual |
| Full Name | DR. ANDREW R LULLOFF |
| Credential | D.D.S. |
| Practice Address |
2353 S Ridge Rd Green Bay WI 54304-5069 |
| Practice Telephone | 9204990471 |
| Practice Fax Number | 9204998312 |
| Mailing Telephone | 9204990471 |
| Mailing Fax Number | 9204998312 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
5143-015 | WI | Dental Providers |
| Street Address |
2353 S RIDGE RD |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304-5069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588688105 | Michael M Miskella | Dentist | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2006-07-27 |
| 1588170716 | Baycare Clinic, LLP | Plastic Surgery | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2017-12-26 |
| 1154869667 | Sarah J Burton | Registered Nurse | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2017-02-03 |
| 1447264502 | David L Lemoine | Dentist | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2006-07-27 |
| 1447274071 | Vijay S Parmar | Dentist | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2006-07-27 |
| 1013921196 | Bradley S Koch | Dentist | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2006-07-27 |
| 1356355424 | Jason L Lemoine | Dentist | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689196255 | Kristen Ashley Haltom | Registered Nurse | 2979 Allied St Suite C, Green Bay, WI 54304 | 2017-07-14 |
| 1649671421 | Heather Marie Novak | Counselor | 2979 Allied St Unit C, Green Bay, WI 54304 | 2014-09-11 |
| 1356777684 | Nathan Weir | Specialist/Technologist | 1265 Lombardi Avenue, Green Bay, WI 54304 | 2013-09-18 |
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1447551379 | Citralina M Haruo | Community Health Worker | 1110 11th Avenue, Green Bay, WI 54304 | 2010-11-09 |
| 1497061352 | Daniel James Gustin | Pharmacist | 1109 Lombardi Ave, Green Bay, WI 54304 | 2010-08-28 |
| 1316259898 | Karen A Detrick | Occupational Therapy Assistant | 1040 Pilgram Way, Woodside Senior Communities, Green Bay, WI 54304 | 2010-07-13 |
| 1861667362 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 2605 S. Oneida St. Suite 107, Green Bay, WI 54304 | 2008-04-25 |
| 1891967303 | Kimberley M Welk | Marriage & Family Therapist | 926 Willard Dr Ste 136, Green Bay, WI 54304 | 2008-03-25 |
| 1750563698 | Richard Lawrence Beyer | Hearing Instrument Specialist | 2154 S Ridge Rd, Green Bay, WI 54304 | 2007-12-03 |
| Find all providers in zip 54304 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801008818 | Thomas Jens Witek | Dentist | 2581 Development Drive, Suite 202, Green Bay, WI 54311 | 2007-05-03 |
| 1689727729 | John Graham Newman | Dentist | 1537 Park Pl Ste 300, Green Bay, WI 54304-1986 | 2007-01-20 |
| 1619336229 | Kenneth Clark | Dentist | 2524 Hillside Heights Dr, Green Bay, WI 54311-6777 | 2016-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
| 1891319273 | Janesville Endodontics | Dentist | 1616 N Randall Ave Ste 180, Janesville, WI 53545-1155 | 2020-06-02 |
| 1306480918 | Teng Kai Ong | Dentist | 1801 West Wisconsin Ave., Milwaukee, WI 53233 | 2019-11-06 |
| 1215344478 | Helen Tsao | Dentist | 2606 Stewart Ave, Ste 102, Wausau, WI 54401-5502 | 2014-07-18 |
| 1275973166 | Meridian Endodontics and Periodontics | Dentist | 20350 Water Tower Blvd Ste 203, Brookfield, WI 53045-3558 | 2013-06-25 |
| 1447698451 | Eva C Dahl | Dentist | 2700 National Dr Ste 1, Onalaska, WI 54650-6708 | 2013-06-12 |
| 1275873374 | F Kris Olsen | Dentist | 1320 S Green Bay Road, Racine Dental Group, Racine, WI 53406 | 2013-02-26 |
| 1063710655 | Erik Daniel Deyoung | Dentist | 6100 W State St, Apt. 636, Wauwatosa, WI 53213-2983 | 2011-03-05 |
| 1376786285 | Ronald David Meyers | Dentist | 2600 N Mayfair Rd Ste 240, Wauwatosa, WI 53226-1309 | 2009-04-08 |
| 1942450457 | Wisconsin Endodontic Group, S.c. | Dentist | 2600 N. Mayfair Rd., Ste 240, Wauwatosa, WI 53226 | 2008-09-22 |
| 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.