NPIMap

Organization Active NPI

Complete Dental Center, S.C.

  • Dentist
  • Antigo, WI
National Provider Identifier
1295819134
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
COMPLETE DENTAL CENTER, S.C.
Practice address
408 State Highway 64
Antigo, WI 54409-8796
Phone
(715) 627-1000
Fax
(715) 627-7123
NPI assigned
Oct 25, 2006
Last updated
Apr 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Authorized official

Name
Dr. Lisa Michelle Krebs, D.D.S.NPI 1447334347
Title
Vice President Dentist
Phone
(715) 627-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

408 State Highway 64
Antigo, WI 54409-8796

Mailing address

408 State Highway 64
Antigo, WI 54409-8796
Phone (715) 627-1000

National Provider Directory

National Provider Directory

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": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1295819134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 STATE HIGHWAY 64",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544098796",
            "telephone_number": "715-627-1000",
            "fax_number": "715-627-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 STATE HIGHWAY 64",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544098796",
            "telephone_number": "715-627-1000",
            "fax_number": "715-627-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE DENTAL CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "KREBS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "VICE PRESIDENT DENTIST",
        "authorized_official_telephone_number": "715-627-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antigo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.