Vanderleest Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

VANDERLEEST DENTAL LLC

Practice address

2502 Lineville Rd
Green Bay, WI 54313-7123

Phone

(920) 434-3950

NPI assigned

May 3, 2022

Last updated

May 3, 2022By 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

Marcus J Vanderleest, DDSNPI 1083722169

Title

Owner

Phone

(920) 434-3950

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marcus James Vanderleest, DDS

  • Dentist
  • Green Bay, WI
  • NPI 1083722169
  NPD Authorized official

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

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1194460162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 LINEVILLE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543137123",
            "telephone_number": "920-434-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 LINEVILLE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543137123",
            "telephone_number": "920-434-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANDERLEEST DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "VANDERLEEST",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-434-3950",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Rose Vander Bloomen, MSN, FNP-C
• Yvonne Vander Heiden, COTA
• Paul David Vander Kelen, D.D.S.
• Katherine Mary Vander Zanden, APNP
• Katherine Vanderheiden, MAC
• Marcus James Vanderleest, DDS
• Diane Lynn Vanderlin, RN MSN APNP C
• Luke Vandermause, PHARMD
• Patricia L Vandermause, LPC ,CSAC
• Margaret Innis Vandermeer, PT

• Dentist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.