Riverside Dental Care LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RIVERSIDE DENTAL CARE LLC

Practice address

1805 E Main St
Little Chute, WI 54140-2455

Phone

(303) 994-1456

NPI assigned

Sep 11, 2023

Organization subpart

No

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

Authorized official

Name

Elese McClarie, DMDNPI 1588183404

Title

Dentist

Phone

(303) 994-1456

Specialties & licenses 1

Addresses

Locations

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

• Elese McClarie, DMD

  • General Practice Dentistry
  • Little Chute, WI
  • NPI 1588183404

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1104603513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 E MAIN ST",
            "city": "LITTLE CHUTE",
            "state": "WI",
            "postal_code": "541402455",
            "telephone_number": "920-423-9131",
            "fax_number": "920-423-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 E MAIN ST",
            "city": "LITTLE CHUTE",
            "state": "WI",
            "postal_code": "541402455",
            "telephone_number": "303-994-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "MCCLARIE",
        "authorized_official_first_name": "ELESE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "303-994-1456",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Little Chute, WI
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.