Active NPI
Lauren Ann Mies, D.D.S.
- Dentist
- Jackson, WI
National Provider Identifier
1174968465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7120-15
- Practice address
- W213N16755 Glen Brooke Dr
Jackson, WI 53037-9489 - Phone
- (262) 677-4990
- NPI assigned
- May 1, 2013
- Last updated
- Jun 18, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7120-15 | WI | Primary |
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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
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 |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Jackson, WI
- NPI 1396342291
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371513600000",
"number": "1174968465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2225 E IVANHOE PL",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532021205",
"telephone_number": "734-748-5509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W213N16755 GLEN BROOKE DR",
"city": "JACKSON",
"state": "WI",
"postal_code": "530379489",
"telephone_number": "262-677-4990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIES",
"first_name": "LAUREN",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-01",
"last_updated": "2013-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "7120-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.