De Pere Family Dentistry LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5001499 Issued in WI

Legal business name

DE PERE FAMILY DENTISTRY LLC

Practice address

1001 N Broadway
De Pere, WI 54115-2609

Phone

(920) 336-2500

Fax

(920) 336-4684

NPI assigned

Dec 20, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Cyril Joseph Van Sistine Jr., D.D.S.

Title

Partner / Manager

Phone

(920) 336-2500

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.

• Moira Kathleen Kraft, D.D.S.

  • General Practice Dentistry
  • De Pere, WI
  • NPI 1881715308
  NPD (past)
• Cyril Joseph Vansistine, Jr., D.D.S.

  • Dentist
  • De Pere, WI
  • NPI 1447373220
  NPD (past)

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1225307267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N BROADWAY",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541152609",
            "telephone_number": "920-336-2500",
            "fax_number": "920-336-4684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N BROADWAY",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541152609",
            "telephone_number": "920-336-2500",
            "fax_number": "920-336-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE PERE FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "VAN SISTINE",
        "authorized_official_first_name": "CYRIL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PARTNER / MANAGER",
        "authorized_official_telephone_number": "920-336-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberlee June Dallmann
• Carla Davis-Teye
• Howard W Davis, M.D.
• Stephanie Davison, BCBA
• De Pere Chiropractic Center, LLC (De Pere Chiropractic Center)
• De Pere Hometown Pharmacy LLC (De Pere Hometown Pharmacy)
• De Pere Smiles Acquisition Company S.C. (De Pere Smiles S.C.)
• Janet Katharina Deleers
• Delorey Chiropractic Clinic, Inc.
• Nathan Daniel Delorey, D.C.

• General Practice Dentistry in De Pere, WI
• Providers in De Pere, 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 Dec 20, 2011; 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.