North Lake Family Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

6346 Issued in WI

Legal business name

NORTH LAKE FAMILY DENTISTRY

Practice address

W315N7641 Hwy 83
Hartland, WI 53029-9759

Phone

(262) 966-7668

NPI assigned

Dec 5, 2014

Last updated

Dec 5, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Patty R Erickson, DDS

Title

Owner

Phone

(262) 966-7668

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Debora Ann Herrick, D.D.S.

  • General Practice Dentistry
  • North Lake, WI
  • NPI 1336360973
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417737600000",
    "number": "1366840456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W315N7641 HWY 83",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530299759",
            "telephone_number": "262-966-7668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W315N7641 HWY 83",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530299759",
            "telephone_number": "262-966-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LAKE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-05",
        "last_updated": "2014-12-05",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "PATTY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-966-7668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WI",
            "license": "6346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1982723920",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Nelson-Zirzow
• James Paul Nevermann, RPH
• New Heights Physical Therapy LLC
• Jennifer A Newcomer, SLP
• Kelly L.M. Newman, D.D.S.
• Lindsay Oksiuta, PT
• Jeanne L Pallagi, MD
• Margaret M Pankow, RN, IBCLC, CLC
• George Chris Panos, D.D.S.
• Leda Patrick, RN

• Dental Clinic/Center in Hartland, WI
• Providers in Hartland, WI by specialty
• Dental Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; 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.