NPIMap

Organization Active NPI

Lake Geneva Dental Care, LLC

Doing business as Milton Dental

  • General Practice Dentistry
  • Milton, WI
National Provider Identifier
1235545419
Registry record updated Jul 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019014858 Issued in IL
Legal business name
LAKE GENEVA DENTAL CARE, LLC
Doing business as
Milton Dental
Practice address
311 Parkview Dr
Milton, WI 53563-1538
Phone
(608) 868-4462
Fax
(608) 868-9725
NPI assigned
Jul 8, 2014
Last updated
Jul 8, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2014

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

Authorized official

Name
Dr. Lawrence Groh, DDSNPI 1639236334
Title
Owner/President
Phone
(630) 833-5110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019014858 IL Primary

Addresses

Primary practice location

311 Parkview Dr
Milton, WI 53563-1538

Mailing address

333 W 1St St
Elmhurst, IL 60126-2641
Phone (630) 833-5110

Other names 1

  • Milton Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beloit Dental2 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.

Locations

311 Parkview Dr
Milton, WI 53563
Phone (313) 575-5292

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404777600000",
    "number": "1235545419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W 1ST ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262641",
            "telephone_number": "630-833-5110",
            "fax_number": "630-833-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 PARKVIEW DR",
            "city": "MILTON",
            "state": "WI",
            "postal_code": "535631538",
            "telephone_number": "608-868-4462",
            "fax_number": "608-868-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE GENEVA DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-08",
        "last_updated": "2014-07-08",
        "status": "A",
        "authorized_official_last_name": "GROH",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "630-833-5110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019014858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Milton Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.