Park Place Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PARK PLACE DENTAL CARE

Practice address

1551 Park PL
Suite 300
Green Bay, WI 54304-1982

Phone

(920) 497-8500

Fax

(920) 497-3213

NPI assigned

Nov 28, 2006

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

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.

• Timothy M. Meyer, D.M.D.

  • General Practice Dentistry
  • Green Bay, WI
  • NPI 1962578252
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467528760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 PARK PL",
            "address_2": "SUITE 300",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543041982",
            "telephone_number": "920-497-8500",
            "fax_number": "920-497-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 PARK PL",
            "address_2": "SUITE 300",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543041982",
            "telephone_number": "920-497-8500",
            "fax_number": "920-497-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paramount Home Care, LLC
• Parc Village Dental, LLC
• Pamela J Pardini, MD
• Yogesh C Pareek, M.D.
• Lisa M Parish, OTR
• Sarah Sun Yee Park, DMD
• Russell Parker, PT
• Parkview Manor Healthcare LLC (Parkview Manor Health and Rehabilitation Center)
• Parkview Nursing and Rehab, LLC
• Alishia Parma

• General Practice Dentistry in Green Bay, WI
• Providers in Green Bay, 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.