Lifetime Dental, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

LIFETIME DENTAL, LLC

Practice address

1507 Tower Ave Ste 202
Superior, WI 54880-2554

Phone

(715) 394-3683

Fax

(715) 394-7315

NPI assigned

May 16, 2023

Organization subpart

No

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

Authorized official

Name

Danielle Rae Lahr

Title

Treatment Coordinator

Phone

(715) 394-3683

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.

• Brent T Johnson, DDS

  • General Practice Dentistry
  • Superior, WI
  • NPI 1194828269
  NPD

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1487345922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 TOWER AVE STE 202",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548802554",
            "telephone_number": "715-394-3683",
            "fax_number": "715-394-7315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 TOWER AVE STE 202",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548802554",
            "telephone_number": "715-394-3683",
            "fax_number": "715-394-7315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "LAHR",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "TREATMENT COORDINATOR",
        "authorized_official_telephone_number": "715-394-3683"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Lepage, COTA/L
• Gregory Michael Lesneski, PA-C
• Christina Marie Leuzzo, OTR/L
• Jason Clyde Leveille, RN
• Megan E. Liebaert
• Jacquelyn K. Lindberg, LPC
• Brooke Lynn Linder, DDS
• Grace Edith Line
• Thomas A Linstroth, DDS
• Gloria Lopez, M.D

• Dental Clinic/Center in Superior, WI
• Providers in Superior, 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 May 16, 2023; 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.