Prairie Run Dental S.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5247015 Issued in WI

Legal business name

PRAIRIE RUN DENTAL S.C.

Practice address

1807 Prairie Drive
Marshfield, WI 54449

Phone

(715) 387-1724

Fax

(715) 384-5310

NPI assigned

May 9, 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

Jaime L Seehafer

Title

Accounts Manager

Phone

(715) 387-1724

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1588878482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 PRAIRIE DRIVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "54449",
            "telephone_number": "715-387-1724",
            "fax_number": "715-384-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 PRAIRIE DRIVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "54449",
            "telephone_number": "715-387-1724",
            "fax_number": "715-384-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE RUN DENTAL S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEEHAFER",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "715-387-1724"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5247015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen M Polga, MD
• Amalia Barroso Pontes, M.D.
• Apurva Chandrakant Popat, MD
• Rachel Popelka
• Prairie Run Dental of Central Wisconsin Inc. (Prairie Run Dental)
• Tara S Preston, NP
• Preventiongenetics LLC
• Jared Lee Pritchard, PHARM.D.
• Professional Breathing Associates Inc (Rotech)
• Donna Prohazka, MD

• 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.