GREAT DAY DENTAL OF MONONA (NPI# 1992217053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992217053 |
| Entity Type | Organization |
| Organization Name | GREAT DAY DENTAL OF MONONA |
| Other Organization Name | GREAT DAY DENTAL OF EAST MADISON |
| Practice Address |
2010 Eastwood Dr Ste 206 Madison WI 53704-5387 |
| Mailing Address |
1532 W Broadway Ste 101 Monona WI 53713-1827 |
| Practice Telephone | 6082411579 |
| Practice Fax Number | 6082412061 |
| Mailing Telephone | 6082213326 |
| Mailing Fax Number | 6082219726 |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2017-10-30 |
| Authorized Official Name | DR. JESSICA KIECKER (OWNER) |
| Authorized Official Telephone | 6082411579 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | Y |
| Parent Organization Name | GREAT DAY DENTAL OF MONONA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
50015111 | WI | Ambulatory Health Care Facilities |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
6337 | WI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Great Day Dental of East Madison | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740792969 | Great Day Dental of Monona | Clinic/Center | 1532 W Broadway Ste 101, Monona, WI 53713-1827 | 2017-10-27 |
| Street Address |
2010 EASTWOOD DR STE 206 |
| City | MADISON |
| State | WI |
| Zip Code | 53704-5387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407369614 | Joseph Michael Oakley II | Chiropractor | 2801 International Ln Ste 102, Madison, WI 53704 | 2017-11-09 |
| 1972015048 | Suzanne Lee | Psychiatry & Neurology | 1835 Winnebago St. #402, Madison, WI 53704 | 2017-10-30 |
| 1831554021 | Gideon Kazah | Licensed Practical Nurse | 2488 Dahle Street, Madison, WI 53704 | 2015-12-15 |
| 1174952220 | Group Health Cooperative of South Central Wisconsin Madison College | Durable Medical Equipment & Medical Supplies | 1705 Hoffman Street, Madison, WI 53704 | 2013-11-08 |
| 1407190127 | Ashley Marie Snyder | Social Worker | 5203 Autumn Leaf Lane, Apt. 389, Madison, WI 53704 | 2012-11-19 |
| 1619230638 | Dawn Lynette Butts | Optometrist | 4208 E Washington Ave, Madison, WI 53704 | 2012-06-25 |
| 1679865992 | Sharon Kelley | Psychologist | 1213 N. Sherman Ave, Suite 334, Madison, WI 53704 | 2011-05-04 |
| 1578730412 | St. Charles Youth & Family Services | Community Based Residential Treatment Facility, Mental Illness | 310 Troy Dr, Cottage B, Madison, WI 53704 | 2008-05-09 |
| 1538346960 | Elizabeth Ann Reiser-loeber | Dentist | 1001 N. Sherman Ave, Madison, WI 53704 | 2008-01-28 |
| 1861683088 | Stephen Dale Flach | Internal Medicine | Covance, 3402 Kinsman Blvd, Madison, WI 53704 | 2007-08-05 |
| Find all providers in zip 53704 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790343051 | Madison Dental Spa | Clinic/Center | 90 Wall St Ste 100, Madison, CT 06443-3128 | 2019-06-03 |
| 1306301072 | Dr. Lee Gus Dunker | Clinic/Center | 424 West St, Madison, IN 47250-3302 | 2019-02-06 |
| 1518422880 | Bright Dental Madison LLC | Clinic/Center | 7866 Mineral Point Rd, Madison, WI 53717-2028 | 2019-01-31 |
| 1770913220 | L.l. Barnett Dental Solutions, P.C. | Clinic/Center | 7185 Highway 72 W Ste C, Madison, AL 35758-6650 | 2013-11-20 |
| 1114210481 | Abcom Family Dental Care | Clinic/Center | 5402 Mineral Point Rd, Madison, WI 53705-4659 | 2011-05-19 |
| 1790976553 | Dr Andrew D Friedman Dmd | Clinic/Center | 21 Old Point Ave, Madison, ME 04950-1114 | 2007-08-07 |
| 1235351750 | Madison Dental Care | Clinic/Center | 535 Gallatin Pike S, Madison, TN 37115-4010 | 2007-05-03 |
| 1386209849 | Southeastern Dental Pllc | Clinic/Center | 117 Gallatin Pike N, Madison, TN 37115-3701 | 2019-05-09 |
| 1417421421 | Kevin L. Klinedinst Dds PC | Clinic/Center | 110 Miles Ridge Rd, Madison, IN 47250-2410 | 2019-01-14 |
| 1417476458 | Madison Dental LLC | Clinic/Center | 2110 Fordem Ave, Madison, WI 53704-4610 | 2017-09-11 |
| Find all providers in MADISON | ||||
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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.