The Grove Family Dental and TMJ Clinic, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

4078 Issued in WI

Legal business name

THE GROVE FAMILY DENTAL AND TMJ CLINIC, LLC

Practice address

109 S Madison St
Evansville, WI 53536-1319

Phone

(608) 882-4441

NPI assigned

Jul 10, 2007

Organization subpart

No

Name

Dr. John Charles Gernetzke, DDS

Title

Member

Phone

(608) 882-4441

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

• Cali Hensel, DDS

  • Dentist
  • Evansville, WI
  • NPI 1699592535
  NPD

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 10, 2007.

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1295933430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S MADISON ST",
            "city": "EVANSVILLE",
            "state": "WI",
            "postal_code": "535361319",
            "telephone_number": "608-882-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S MADISON ST",
            "city": "EVANSVILLE",
            "state": "WI",
            "postal_code": "535361319",
            "telephone_number": "608-882-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GROVE FAMILY DENTAL AND TMJ CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "GERNETZKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "608-882-4441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "4078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Standish
• Blase William Strobl, PT
• Kimberly Anne Tedesco, PT
• Kapil Thacker, DMD
• Ellen Thalacker
• Abbey Tway
• Rachel Grace Tyler, PTA
• Uro GYN Health Services, LLC
• Austin Henry Westra
• Melanie E. White, D.D.S.

• All providers in Evansville, WI
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.