Johnson Creek Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JOHNSON CREEK DENTAL

Practice address

540 Village Walk Lane
Suite E
Johnson Creek, WI 53038

Phone

(920) 699-2554

Fax

(920) 699-3059

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Johathon J Melk, DDS

Title

Dentist

Phone

(920) 690-2554

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Shonna Marie Jorgensen, D.D.S.

  • General Practice Dentistry
  • Johnson Creek, WI
  • NPI 1811179559
  NPD (past)
• Jonathon J Melk, D.D.S.

  • General Practice Dentistry
  • Johnson Creek, WI
  • NPI 1821232760
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225124571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 VILLAGE WALK LANE",
            "address_2": "SUITE E",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "53038",
            "telephone_number": "920-699-2554",
            "fax_number": "920-699-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 VILLAGE WALK LANE",
            "address_2": "SUITE E",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "53038",
            "telephone_number": "920-699-2554",
            "fax_number": "920-699-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON CREEK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MELK",
        "authorized_official_first_name": "JOHATHON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "920-690-2554",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Hovey
• Elizabeth Ann Hunkins, LCSW
• Cathy Ann Hunter, PA
• Johnson Creek ASC LLC
• Johnson Creek Counseling & Wellness Center LLC
• Johnson Creek Fire EMS Dept.
• Johnson Creek School District
• Shonna Marie Jorgensen, D.D.S.
• Barbara J Kelly, OTR
• Luxottica of America Inc (Oakley B834)

• General Practice Dentistry in Johnson Creek, WI
• Providers in Johnson Creek, 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.