Advanced Dental Care Clinic SC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ADVANCED DENTAL CARE CLINIC SC

Practice address

62 S Pleasant View Road
Plymouth, WI 53073

Phone

(920) 892-8466

NPI assigned

Nov 8, 2017

Organization subpart

No

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

Authorized official

Name

Hooman Sereshki, DDS

Title

Owner

Phone

(920) 892-8466

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576195200000",
    "number": "1396258752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 S PLEASANT VIEW RD",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530734954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 S PLEASANT VIEW ROAD",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "53073",
            "telephone_number": "920-892-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL CARE CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-08",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A",
        "authorized_official_last_name": "SERESHKI",
        "authorized_official_first_name": "HOOMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-892-8466",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 20-20 Visions LLC
• Hooman Abdolisereshki, DDS
• Dillon Norbert Abhold, PHARMD
• Mitchell Adams
• Advanced Dental Care, S.C.
• Advanced Eyecare, SC
• Aegis Group Practice LLC
• Alexis Root LCSW LLC
• Melinda Holly Altman, ARNP

• All providers in Plymouth, WI
• Dental Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.