Family Dentistry SC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FAMILY DENTISTRY SC

Practice address

135 W Second Street
New Richmond, WI 54017

Phone

(715) 246-6603

Fax

(715) 246-6649

NPI assigned

Nov 2, 2006

Last updated

Aug 22, 2020By 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

John Lee Mike, DDSNPI 1457448714

Title

Dentist

Phone

(715) 246-6493

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Family Dentistry SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Family Dentistry SC

  • General Practice Dentistry
  • Roberts, WI
  • NPI 1063687150
  NPD tax ID

Practitioners 3

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.

• John Lee Mike, DDS

  • Dentist
  • New Richmond, WI
  • NPI 1457448714
  NPD (past) Authorized official
• Kellie Diane Lindquist, DDS

  • Dentist
  • New Richmond, WI
  • NPI 1285721530
  NPD (past)
• Douglas George Stai, DDS

  • Dentist
  • New Richmond, WI
  • NPI 1619051042
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205915287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W SECOND STREET",
            "address_2": "PO BOX 55",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "54017",
            "telephone_number": "715-246-6603",
            "fax_number": "715-246-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W SECOND STREET",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "54017",
            "telephone_number": "715-246-6603",
            "fax_number": "715-246-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "715-246-6493",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38370900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ericksons Diversified LLC (Family Fresh Market Pharmacy)
• Essential Eyecare, LLC
• Every Voice Matters Speech and Feeding Therapy LLC
• Judith Ann Fall, OTR/L
• Amber E Falls, CSAC
• Family Medical Center, SC
• Family Therapy Associates, LLC
• Nicole Beverly Feser, DNP, CNP
• Aimee Flatten, OTA
• Nicholas Dean Flier, LPCC

• General Practice Dentistry in New Richmond, WI
• Providers in New Richmond, 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 Aug 22, 2020; 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.