NPIMap

Organization Active NPI

Zander Dental SC

  • Dentist
  • Shawano, WI
National Provider Identifier
1073598165
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2262015 Issued in WI
Legal business name
ZANDER DENTAL SC
Practice address
152 Woodlawn Dr
Shawano, WI 54166-2200
Phone
(715) 526-3314
Fax
(715) 524-9893
NPI assigned
Dec 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jeffrey L Zander, DDSNPI 1477536613
Title
Dentist
Phone
(715) 526-3314

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2262015 WI Primary

Addresses

Primary practice location

152 Woodlawn Dr
Shawano, WI 54166-2200

Mailing address

152 Woodlawn Dr
Shawano, WI 54166-2200
Phone (715) 526-3314

Other identifiers 1

IdentifierTypeStateIssuer
33386000MedicaidWI

National Provider Directory

National Provider Directory

Locations

152 Woodlawn Dr
Shawano, WI 54166
Phone (715) 526-3314

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073598165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 WOODLAWN DR",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662200",
            "telephone_number": "715-526-3314",
            "fax_number": "715-524-9893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 WOODLAWN DR",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662200",
            "telephone_number": "715-526-3314",
            "fax_number": "715-524-9893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZANDER DENTAL SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZANDER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "715-526-3314",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "2262015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33386000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawano, WI

Sources for this page

  • 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.