DR. KEVIN CLYDE POTTER (NPI# 1891751582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891751582 |
| Entity Type | Individual |
| Full Name | DR. KEVIN CLYDE POTTER |
| Credential | DDS |
| Practice Address |
1804 Warden St Eau Claire WI 54703 |
| Practice Telephone | 7158348484 |
| Mailing Telephone | 7158348484 |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 3070015 | WI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33447500 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831355643 | Kevin Wayne Potter | Surgery | 7330 N 99th Ave Ste 325, Glendale, AZ 85307-3022 | 2008-07-31 |
| 1881725349 | Kevin Potter | Case Manager/Care Coordinator | 1280 Main St, 3rd Floor, Buffalo, NY 14209-1912 | 2007-03-08 |
| Street Address |
1804 WARDEN ST |
| City | EAU CLAIRE |
| State | WI |
| Zip Code | 54703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114535929 | Eclipse Counseling LLC | Clinic/Center | 1136 Barron St, Eau Claire, WI 54703 | 2020-07-17 |
| 1982261012 | Melissa Mae Jenneman | Social Worker | 306 Broadway Street, Eau Claire, WI 54703 | 2019-05-23 |
| 1396217014 | Jennifer Grace Joos | Case Manager/Care Coordinator | 2523 Diane Ln, Eau Claire, WI 54703 | 2018-12-19 |
| 1811437346 | Phillip Dolan | Specialist/Technologist | 2801 E Princeton Ave, Eau Claire, WI 54703 | 2017-03-02 |
| 1467830463 | Ryan Behnke | Specialist/Technologist | 725 Hudson St., Eau Claire, WI 54703 | 2015-05-11 |
| 1366737769 | Eric D. Carlson | Dentist | 1020 Menomonie Street, Eau Claire, WI 54703 | 2011-06-14 |
| 1669782587 | Jennifer Jean Andersen | Registered Nurse | 2027 West Ridge Dr., Eau Claire, WI 54703 | 2010-10-13 |
| 1407011257 | Scott R Lau | Hearing Instrument Specialist | 1802 Galloway Street, Eau Claire, WI 54703 | 2008-07-22 |
| 1134316615 | Robert G Grayson | Dentist | 2725 Morningside Dr, Eau Claire, WI 54703 | 2007-09-28 |
| 1689880858 | Okie Earl Allen | Hearing Instrument Specialist | 616 Lamplighter Ct, Eau Claire, WI 54703 | 2007-05-15 |
| Find all providers in zip 54703 | ||||
| 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 |
|---|---|---|---|---|
| 1003475203 | Nicholas Miskulin | Dentist | 615 W Clairemont Ave # 120, Eau Claire, WI 54701-6223 | 2019-06-11 |
| 1316467517 | So Hee Kim | Dentist | 3809 Oakwood Mall Dr # C, Eau Claire, WI 54701-3042 | 2017-06-20 |
| 1134408966 | Clearwater Dental Sc | Dentist | 431 E Clairemont Ave Ste B, Eau Claire, WI 54701-3685 | 2011-08-10 |
| 1366737769 | Eric D. Carlson | Dentist | 1020 Menomonie Street, Eau Claire, WI 54703 | 2011-06-14 |
| 1982858247 | Phillip R Douglas | Dentist | 4850 Keystone Xing, Eau Claire, WI 54701-5076 | 2008-11-12 |
| 1710155569 | Thomas William Machgan | Dentist | 3522 Oakwood Hills Pkwy, Eau Claire, WI 54701-9299 | 2008-02-14 |
| 1063693331 | William A Woehrmann Dds Sc | Dentist | 2125 Heights Dr Ste 2c, Eau Claire, WI 54701-6146 | 2007-11-15 |
| 1659569549 | Maximillian Anton Menacher Jr. | Dentist | 1025 N Hastings Way, Suite 3, Eau Claire, WI 54703-1898 | 2007-10-05 |
| 1134316615 | Robert G Grayson | Dentist | 2725 Morningside Dr, Eau Claire, WI 54703 | 2007-09-28 |
| 1679783443 | Regis Court Family Dental S.c. | Dentist | 1102 Regis Court, Eau Claire, WI 54701 | 2007-05-23 |
| Find all providers in EAU CLAIRE | ||||
| City | EAU CLAIRE |
| Zip Code | 54703 |
Please comment or provide details below to improve the information on DR. KEVIN CLYDE POTTER.
| 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.