Wausau Family Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WAUSAU FAMILY DENTAL, LLC

Doing business as

Wausau Family Dental

Practice address

3650 Stewart Ave
Wausau, WI 54401-4170

Phone

(715) 845-3171

Fax

(715) 843-7088

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Todd Hehli

Title

Dentist

Phone

(715) 833-8755

Specialties & licenses 1

Addresses

Other names 1

• Wausau Family Dental Doing business as

Locations

Practitioners 1

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.

• Denise Long

  • General Practice Dentistry
  • Wausau, WI
  • NPI 1114119534
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1053489708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 STEWART AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014170",
            "telephone_number": "715-845-3171",
            "fax_number": "715-843-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 STEWART AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014170",
            "telephone_number": "715-845-3171",
            "fax_number": "715-843-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUSAU FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "HEHLI",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "715-833-8755"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wausau Family Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wausau Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Wausau, WI
• Providers in Wausau, 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 Jul 21, 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.