Organization Active NPI

Northpark Dental - Chippewa

  • General Practice Dentistry
  • Chippewa Falls, WI
National Provider Identifier
1508932815
Registry record updated Feb 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NORTHPARK DENTAL - CHIPPEWA
Practice address
235 W Prairie View Rd
Suite 1
Chippewa Falls, WI 54729-3639
Phone
(715) 720-9125
Fax
(715) 720-1475
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2010

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

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

235 W Prairie View Rd
Suite 1
Chippewa Falls, WI 54729-3639

Mailing address

235 W Prairie View Rd
Suite 1
Chippewa Falls, WI 54729-3639
Phone (715) 720-9125

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265587200000",
    "number": "1508932815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 W PRAIRIE VIEW RD",
            "address_2": "SUITE 1",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547293639",
            "telephone_number": "715-720-9125",
            "fax_number": "715-720-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W PRAIRIE VIEW RD",
            "address_2": "SUITE 1",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547293639",
            "telephone_number": "715-720-9125",
            "fax_number": "715-720-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHPARK DENTAL - CHIPPEWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2010-02-08",
        "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": []
}

Other providers in Chippewa Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; 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.