NPIMap

Organization Active NPI

St. Croix Tribal Council

Doing business as St. Croix Tribal Dental

  • General Practice Dentistry
  • Webster, WI
National Provider Identifier
1013128685
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ST. CROIX TRIBAL COUNCIL
Doing business as
St. Croix Tribal Dental
Practice address
4404 State Road 70
Webster, WI 54893-9251
Phone
(715) 349-8554
NPI assigned
May 25, 2007
Last updated
Oct 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Amber Heinz
Title
Health Director
Phone
(715) 349-8554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4404 State Road 70
Webster, WI 54893-9251

Mailing address

4404 State Road 70
Webster, WI 54893-9251
Phone (715) 349-8554

Other names 1

  • St. Croix Tribal Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Croix Tribal Council7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1013128685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 STATE ROAD 70",
            "city": "WEBSTER",
            "state": "WI",
            "postal_code": "548939251",
            "telephone_number": "715-349-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 STATE ROAD 70",
            "city": "WEBSTER",
            "state": "WI",
            "postal_code": "548939251",
            "telephone_number": "715-349-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CROIX TRIBAL COUNCIL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "HEINZ",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "715-349-8554"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Croix Tribal Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Croix Tribal Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Webster, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.