NPIMap

Organization Active NPI

First Impressions of Medford

  • Dental Clinic/Center
  • Medford, WI
National Provider Identifier
1447531827
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
FIRST IMPRESSIONS OF MEDFORD
Practice address
124 S Main St
Medford, WI 54451-1841
Phone
(715) 748-5435
NPI assigned
Aug 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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

Authorized official

Name
Kim Seehafer
Title
Accountant
Phone
(715) 842-4649

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

124 S Main St
Medford, WI 54451-1841

Mailing address

PO Box 48
Schofield, WI 54476-0048
Phone (715) 748-5435

Other identifiers 1

IdentifierTypeStateIssuer
38388300MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
First Impressions Dental East SC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

124 S Main St
Medford, WI 54451
Phone (715) 748-5435

Practitioners & affiliated clinicians

Practitioners 3

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": "1314662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314662400000",
    "number": "1447531827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48",
            "city": "SCHOFIELD",
            "state": "WI",
            "postal_code": "544760048",
            "telephone_number": "715-748-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 S MAIN ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511841",
            "telephone_number": "715-748-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST IMPRESSIONS OF MEDFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-30",
        "last_updated": "2011-08-30",
        "status": "A",
        "authorized_official_last_name": "SEEHAFER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "715-842-4649"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38388300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; 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.