Meadowbrook Smiles

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

15-5497 Issued in WI

Legal business name

MEADOWBROOK SMILES

Practice address

2550 Glendale Ave
Green Bay, WI 54313-6849

Phone

(920) 434-3900

Fax

(920) 434-6980

NPI assigned

Apr 18, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Rebecca P Vanmiller, DDS

Title

Owner

Phone

(920) 366-5068

Specialties & licenses 2

Addresses

Other names 1

• Timbercreek Smiles Other name

Locations

Practitioners 2

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

• Jordan Jon Annis

  • Dentist
  • Elm Grove, WI
  • NPI 1548873292
  NPD (past)
• John J Quinlan, DDS

  • General Practice Dentistry
  • Green Bay, WI
  • NPI 1245364462
  NPD (past)

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1225525959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 GLENDALE AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543136849",
            "telephone_number": "920-434-3900",
            "fax_number": "920-434-6980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 GLENDALE AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543136849",
            "telephone_number": "920-434-3900",
            "fax_number": "920-434-6980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1926 Dickinson Rd",
            "address_purpose": "LOCATION",
            "city": "DE Pere",
            "state": "WI",
            "postal_code": "541159213",
            "country_code": "US",
            "telephone_number": "920-434-3900",
            "fax_number": "920-434-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEADOWBROOK SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "VANMILLER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-366-5068",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WI",
            "license": "15-5497",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WI",
            "license": "1001549-15",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Timbercreek Smiles",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lacey McRoy, PT
• Jean Marie McWey, M.S. CCC-SLP
• MDC Bellevue, L.L.C.
• Jacob Mead
• Robert Charles Mead, MD
• Kathryn Meadowcroft, FNP
• Medequipment & Supplies
• Medical Arts Complex Dental Center, S.C.
• Medication Innovations L.L.C.
• Michael G Medich, MD

• Dental Clinic/Center in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Dental Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.