Winneconne Family Dentistry Acquisition LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

WINNECONNE FAMILY DENTISTRY ACQUISITION LLC

Practice address

902 E Main St
Winneconne, WI 54986-9782

Phone

(920) 705-1123

NPI assigned

Mar 6, 2023

Last updated

Mar 6, 2023By 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

Julie VandeheyNPI 1376036343

Title

Dentist

Phone

(920) 229-7092

Specialties & licenses 1

Addresses

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.

• Julie Vandehey

  • General Practice Dentistry
  • Winneconne, WI
  • NPI 1376036343
  NPD Authorized official

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1093415283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520",
            "city": "WINNECONNE",
            "state": "WI",
            "postal_code": "549860520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 E MAIN ST",
            "city": "WINNECONNE",
            "state": "WI",
            "postal_code": "549869782",
            "telephone_number": "920-705-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINNECONNE FAMILY DENTISTRY ACQUISITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "VANDEHEY",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "920-229-7092"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Upper Lakes Dental, LLC
• Julie Vandehey
• Winnebago Wellness LLC (Winnebago Wellness Chiropractic)
• Winneconne Chiropractic and Sports Rehab LLC
• Winneconne Family Dentistry
• Winneconne Hometown Pharmacy LLC (Winneconne Hometown Pharmacy)
• Winneconne School District
• Brian P Yonke, R.N.

• Dental Clinic/Center in Winneconne, WI
• Providers in Winneconne, WI by specialty
• Dental Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.