NPIMap

Organization Active NPI

Steven R. Lindstrom D.D.S., S.C.

  • Dentist
  • Howards Grove, WI
National Provider Identifier
1215339130
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2295 Issued in WI
Legal business name
STEVEN R. LINDSTROM D.D.S., S.C.
Practice address
617 Ethan Allen Dr
Howards Grove, WI 53083-1267
Phone
(920) 565-3369
Fax
(920) 565-3360
NPI assigned
Sep 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Authorized official

Name
Dr. Steven Robert Lindstrom, D.D.S.NPI 1407895519
Title
President
Phone
(920) 565-3369

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2295 WI Primary

Addresses

Primary practice location

617 Ethan Allen Dr
Howards Grove, WI 53083-1267

Mailing address

617 Ethan Allen Dr
Howards Grove, WI 53083-1267
Phone (920) 565-3369

National Provider Directory

National Provider Directory

Locations

617 Ethan Allen Dr
Howards Grove, WI 53083
Phone (920) 565-3369

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411430400000",
    "number": "1215339130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 ETHAN ALLEN DR",
            "city": "HOWARDS GROVE",
            "state": "WI",
            "postal_code": "530831267",
            "telephone_number": "920-565-3369",
            "fax_number": "920-565-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 ETHAN ALLEN DR",
            "city": "HOWARDS GROVE",
            "state": "WI",
            "postal_code": "530831267",
            "telephone_number": "920-565-3369",
            "fax_number": "920-565-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN R. LINDSTROM D.D.S., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A",
        "authorized_official_last_name": "LINDSTROM",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-565-3369",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "2295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howards Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.