NPIMap

Organization Active NPI

Howards Grove Family Dental, LLC

  • General Practice Dentistry
  • Howards Grove, WI
National Provider Identifier
1023603230
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HOWARDS GROVE FAMILY DENTAL, LLC
Practice address
617 Ethan Allen Dr
Howards Grove, WI 53083-1267
Phone
(920) 565-3369
Fax
(920) 565-3360
NPI assigned
Mar 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Authorized official

Name
Dr. Noemi G Garcia Beiersdorf, DDS
Title
Dentist
Phone
(414) 460-8575

Specialties & licenses 1

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

Addresses

Primary practice location

617 Ethan Allen Dr
Howards Grove, WI 53083-1267

Mailing address

617 Ethan Allen Dr
Howards Grove, WI 53083-1267
Phone (920) 565-3369

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1023603230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 ETHAN ALLEN DR",
            "city": "HOWARDS GROVE",
            "state": "WI",
            "postal_code": "530831267",
            "telephone_number": "920-565-3369",
            "fax_number": "920-565-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 ETHAN ALLEN DR",
            "city": "HOWARDS GROVE",
            "state": "WI",
            "postal_code": "530831267",
            "telephone_number": "920-565-3369",
            "fax_number": "920-565-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOWARDS GROVE FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-09",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "GARCIA BEIERSDORF",
        "authorized_official_first_name": "NOEMI",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "414-460-8575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howards Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.