Dental Associates of Lake Mills, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

3647 Issued in WI

Legal business name

DENTAL ASSOCIATES OF LAKE MILLS, INC.

Practice address

311 E Tyranena Park Rd
Lake Mills, WI 53551-9681

Phone

(920) 648-2331

Fax

(920) 648-3437

NPI assigned

Aug 7, 2008

Organization subpart

No

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

Authorized official

Name

Diane M. Schleicher

Title

Office Administrator

Phone

(920) 648-2331

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaclyn Benish

  • General Practice Dentistry
  • Lake Mills, WI
  • NPI 1942347604
  NPD (past)
• Juliet Anne Slavens, D.D.S.

  • Dentist
  • Lake Mills, WI
  • NPI 1649294224
  NPD (past)

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1629224852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E TYRANENA PARK RD",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535519681",
            "telephone_number": "920-648-2331",
            "fax_number": "920-648-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 E TYRANENA PARK RD",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535519681",
            "telephone_number": "920-648-2331",
            "fax_number": "920-648-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ASSOCIATES OF LAKE MILLS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-07",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "SCHLEICHER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "920-648-2331"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "3647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33489300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33794300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Caucutt, PTA
• Christopher James Kroll LLC
• City of Lake Mills
• Sarah Clement, M.A. CCC-SLP
• Country Cares LLC
• Ear Clinic, LLC
• Lynne M. Edebohls, APNP
• Emily Enstad, ATR, LPC
• Extendicare Health Facilities, Inc.
• Steven John Fahsel, DDS

• Dentist in Lake Mills, WI
• Providers in Lake Mills, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; 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.