DRS. Paul M Godich and Mark a Dagenais Optometrists LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DRS. PAUL M GODICH AND MARK A DAGENAIS OPTOMETRISTS LLC

Practice address

10555 W Parnell Ave
Hales Corners, WI 53130-2000

Phone

(414) 425-4141

Fax

(414) 425-4230

NPI assigned

Nov 25, 2013

Last updated

Feb 19, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Dagenais, OD

Title

Partner

Phone

(414) 425-4141

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1184054363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10555 W PARNELL AVE",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302000",
            "telephone_number": "414-425-4141",
            "fax_number": "414-425-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10555 W PARNELL AVE",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302000",
            "telephone_number": "414-425-4141",
            "fax_number": "414-425-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. PAUL M GODICH AND MARK A DAGENAIS OPTOMETRISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-25",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "DAGENAIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "414-425-4141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Hales Corners, WI
• Providers in Hales Corners, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.