Generations Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3547WI Issued in WI

Legal business name

GENERATIONS FAMILY DENTAL

Practice address

2505 N Mayfair Rd
#103
Wauwatosa, WI 53226

Phone

(414) 258-2117

Fax

(414) 258-4177

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Fred A Lacourt, DDS

Title

Dentist

Phone

(414) 258-2117

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1184793580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 N MAYFAIR RD",
            "address_2": "#103",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-258-2117",
            "fax_number": "414-258-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 N MAYFAIR RD",
            "address_2": "#103",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-258-2117",
            "fax_number": "414-258-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERATIONS FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "LACOURT",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "414-258-2117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3547WI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "690859",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "98924",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gateway Therapies, LLC
• Stephanie A Gauthier, LPC-IT
• Gregg Michael Gaylord, MD
• Teresa O Geisberger, P.T
• Mitchell Hunter Geisler
• Generations Family Dental Care-Tosa, LLC
• Wendy Gensch, OTR
• Patricia Rae Genthe, PT
• Fiona George, CPM
• Ross George, PTA

• General Practice Dentistry in Wauwatosa, WI
• Providers in Wauwatosa, 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 Jun 22, 2015; 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.