Twin Ports Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TWIN PORTS DENTAL

Practice address

1507 Tower Ave
Room 427
Superior, WI 54880-2532

Phone

(715) 394-5792

NPI assigned

Jul 22, 2010

Organization subpart

No

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

Authorized official

Name

Genie Kuble

Title

Contact Officer

Phone

(920) 450-0157

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Richard Mathias Johnson, DDS

  • Dentist
  • Superior, WI
  • NPI 1376587279
  NPD (past)
• Neil Olson

  • General Practice Dentistry
  • Superior, WI
  • NPI 1538472907
  NPD (past)

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279756800000",
    "number": "1114230968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 TOWER AVE",
            "address_2": "ROOM 427",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548802532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 TOWER AVE",
            "address_2": "ROOM 427",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548802532",
            "telephone_number": "715-394-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN PORTS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A",
        "authorized_official_last_name": "KUBLE",
        "authorized_official_first_name": "GENIE",
        "authorized_official_title_or_position": "CONTACT OFFICER",
        "authorized_official_telephone_number": "920-450-0157"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacinta Mary Traxler, OTR/L
• Mitchell Lee Tschakert, DDS
• Richard Fredolph Tunell, LPCC
• Dawn Marie Turchi, LICSW
• Twin Ports Clinic of Chiropractic Inc
• Twin Ports Health Solutions SC
• Ronald Keith Underdale, DDS
• Rachel Nicole Ursin-Schiff, MS/CCC SLP
• Lorena Valente
• Melvin Varughese, DMD

• General Practice Dentistry in Superior, WI
• Providers in Superior, 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 22, 2010; 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.