Greenbayctd LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GREENBAYCTD LLC

Practice address

2280 Holmgren Way
Green Bay, WI 54304-4710

Phone

(920) 489-3491

NPI assigned

Apr 16, 2021

Last updated

Apr 16, 2021By 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

Mitch Weiland

Title

Assistant Controller

Phone

(608) 343-0818

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1023699576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 EXCELSIOR DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 HOLMGREN WAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044710",
            "telephone_number": "920-489-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBAYCTD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "WEILAND",
        "authorized_official_first_name": "MITCH",
        "authorized_official_title_or_position": "ASSISTANT CONTROLLER",
        "authorized_official_telephone_number": "608-343-0818"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• G. Lynn Green, APNP
• Katherine A. Green, M.D.
• Katie Rose Green
• Sean Green
• Dawn Marie Greenawald
• Cameron Greene, MS, LAT, ATC
• Justin Lee Greene, MD
• Richard C Greene, MD
• Michelle Marie Greenheck, DPT
• Greenmed Move LLC

• Dentist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.