Laura Elizabeth Goodell, D.M.D.
Individual provider Active NPI Pediatric Dentistry · West Milwaukee, WI
NPI 1346535002 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1346535002
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 1001695 (WI)
- Practice address
- 2100 Miller Park Way
West Milwaukee, WI 53219-1641 - Phone
- (262) 436-3363
- NPI assigned
- Jun 10, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180307000592 | WI | Order and Referring Only - Dentist |
0547489668 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30-023846 | OH | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bright Side Pediatric Dentistry LLC | Pediatric Dentistry | Current | Accepting new patients |
| Dental Associates LTD of Wisconsin | Pediatric Dentistry | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 30-023846 | OH | |
| Pediatric Dentistry | 1223P0221X | 1001695 | WI | Yes |
Addresses
Primary practice location
2100 Miller Park Way
West Milwaukee, WI 53219-1641
Mailing address
N97W14947 Burning Bush CT
Germantown, WI 53022-6628
Phone (608) 712-8195
Other practice location 1
1211 Dolphin Ct
Waukesha, WI 53186-1488
Phone (262) 436-3363
Other names
- Laura Elizabeth Battaglia
Other providers in West Milwaukee, WI
- Fresh Coast Dental I LLC
- Lynn A Garnaas
- Pamela Ann Gentile
- Aleksandr Gershteyn
- Epiphany A Gold
- Sandra Graham
- Great Lakes Orthotics & Medical Supply, Inc.
- Michael Gremban
- Trista M Grudzinski
- Audra L Hale
All providers in West Milwaukee, WI · Pediatric Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.