NPIMap

Organization Active NPI

St. Croix Valley Dental, PLLC

  • Point of Service
  • Hudson, WI
National Provider Identifier
1265618862
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
Legal business name
ST. CROIX VALLEY DENTAL, PLLC
Practice address
1003 Pearson Dr.
Hudson, WI 54016
Phone
(715) 377-9966
Fax
(715) 377-9933
NPI assigned
Jan 14, 2008
Organization subpart
Yes
Parent organization
ST. CROIX VALLEY DENTAL, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Douglas S. Wolff, D.D.S.
Title
Pwner
Phone
(651) 439-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X WI Primary

Addresses

Primary practice location

1003 Pearson Dr.
Hudson, WI 54016

Mailing address

13961 60TH St North
Stillwater, MN 55082
Phone (651) 439-2600

Other names 1

  • DBA/ Carmichael Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Minneapolis-St Paul Periodontics12 organizations share this tax ID, including this one
Part of
Minneapolis-St Paul Periodontics

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

13961 60th St N
Stillwater, MN 55082
Phone (651) 439-2600

Practitioners & affiliated clinicians

Practitioners 2

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": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1265618862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13961 60TH ST NORTH",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "55082",
            "telephone_number": "651-439-2600",
            "fax_number": "651-439-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 PEARSON DR.",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "54016",
            "telephone_number": "715-377-9966",
            "fax_number": "715-377-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CROIX VALLEY DENTAL, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. CROIX VALLEY DENTAL, PLLC",
        "enumeration_date": "2008-01-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PWNER",
        "authorized_official_telephone_number": "651-439-2600",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA/ Carmichael Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.