NPIMap

Sheridan Michaud

Individual provider Active NPI General Practice Dentistry · Pulaski, WI

NPI 1124876412 · NPPES record last updated Jan 29, 2025

Key facts

NPI
1124876412
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
6001478-15 (WI)
Practice address
985 Corporate Way
Pulaski, WI 54162-2701
Phone
(920) 822-8388
NPI assigned
May 10, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6001478-15WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Abh Dental Enterprises Current
since May 12, 2024		 Accepting new patients
Pulaski Sleep LLC Current
since May 12, 2024		 Accepting new patients

Locations

985 Corporate Way
Pulaski, WI 54162
Phone (920) 265-3371

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 6001478-15 WI Yes

Addresses

Primary practice location

985 Corporate Way
Pulaski, WI 54162-2701

Mailing address

2603 Nicolet Dr
Green Bay, WI 54311-7221
Phone (920) 634-9350

Other providers in Pulaski, WI

All providers in Pulaski, WI · General Practice Dentistry in Wisconsin

Sources for this page

Verify at the official NPI Registry.