Lauren Ann Mies, D.D.S.
Individual provider Active NPI Dentist · Jackson, WI
NPI 1174968465 · NPPES record last updated Jun 18, 2013
Key facts
- NPI
- 1174968465
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 7120-15 (WI)
- Practice address
- W213N16755 Glen Brooke Dr
Jackson, WI 53037-9489 - Phone
- (262) 677-4990
- NPI assigned
- May 1, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7120-15 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bloy Family Dentistry LLC | Dentist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7120-15 | WI | Yes |
Addresses
Primary practice location
W213N16755 Glen Brooke Dr
Jackson, WI 53037-9489
Mailing address
2225 E Ivanhoe PL
Milwaukee, WI 53202-1205
Phone (734) 748-5509
Other providers in Jackson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.