Mapleleaf Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MAPLELEAF DENTAL

Practice address

504 S Chestnut Ave
Marshfield, WI 54449-3604

Phone

(715) 384-3515

NPI assigned

Apr 26, 2007

Last updated

Aug 22, 2020By 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

Genie Kuble

Title

Contact Officer

Phone

(920) 450-0157

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417177916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 S CHESTNUT AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544493604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 S CHESTNUT AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544493604",
            "telephone_number": "715-384-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLELEAF DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUBLE",
        "authorized_official_first_name": "GENIE",
        "authorized_official_title_or_position": "CONTACT OFFICER",
        "authorized_official_telephone_number": "920-450-0157"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Christine Malyuk, FNP
• Ruzhual Kaur Man
• Oscar F. Mandes, LCSW
• Muhammad Shaheer Mannan
• William F Manor, DO
• Suzanne Lynn Marcon-Fuller
• Amy L Marek-Brady, RN
• Samantha A Marquez, PA-C
• Dreese Marrakchi
• Marriage & Family Health Services, LTD.

• General Practice Dentistry in Marshfield, WI
• Providers in Marshfield, WI by specialty
• General Practice Dentistry in Wisconsin

• 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.