Healthy Teeth Green Bay SC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HEALTHY TEETH GREEN BAY SC

Practice address

2324 Old Plank Rd
De Pere, WI 54115-8618

Phone

(623) 434-9343

Fax

(623) 321-6268

NPI assigned

Jul 22, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rachel Razo

Title

Credentialing

Phone

(623) 434-9343

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003837139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 W PARKSIDE LN",
            "address_2": "SUITE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271228",
            "telephone_number": "623-434-9343",
            "fax_number": "623-321-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 OLD PLANK RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541158618",
            "telephone_number": "623-434-9343",
            "fax_number": "623-321-6268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY TEETH GREEN BAY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAZO",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "623-434-9343"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaceson L. Hauser, DC
• Ryan Havlovitz, PT
• Kristel Lyn Hawley, LPC
• Savanna Joy Hayes, LCSW
• Ashleigh Hayward, M.S.CCC-SLP
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• Heartland Hospice Services LLC (Heartland Home Health Care and Hospice)
• Heartland Hospice Services, LLC (ProMedica Hospice (Green Bay))
• Kristen Hebbard
• Heintzkill Chiropractic Plus LLC

• General Practice Dentistry in De Pere, WI
• Providers in De Pere, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.