NPIMap

Organization Active NPI

Timber Drive Dental Inc.

  • Dentist
  • Rhinelander, WI
National Provider Identifier
1356476774
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4504 Issued in WI
Legal business name
TIMBER DRIVE DENTAL INC.
Practice address
521 E Timber Dr
Rhinelander, WI 54501-2855
Phone
(715) 365-1800
Fax
(715) 365-1806
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Leonard Fralick Jr., D.D.S.
Title
Dentist
Phone
(715) 365-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 4504 WI Primary

Addresses

Primary practice location

521 E Timber Dr
Rhinelander, WI 54501-2855

Mailing address

PO Box 579
Rhinelander, WI 54501-0579
Phone (715) 365-1800

Other names 1

  • Paco Fralick D.D.S. Other name

National Provider Directory

National Provider Directory

Locations

521 E Timber Dr
Rhinelander, WI 54501
Phone (715) 365-1800

Practitioners & affiliated clinicians

Practitioners 1

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": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356476774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545010579",
            "telephone_number": "715-365-1800",
            "fax_number": "715-365-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E TIMBER DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545012855",
            "telephone_number": "715-365-1800",
            "fax_number": "715-365-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMBER DRIVE DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRALICK",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "715-365-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "4504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paco Fralick D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rhinelander, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.