Neighborhood Smiles of West Salem, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

NEIGHBORHOOD SMILES OF WEST SALEM, LLC

Practice address

1403 Waterloo Ave
West Salem, WI 54669-9270

Phone

(608) 519-4385

NPI assigned

May 31, 2018

Organization subpart

No

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

Authorized official

Name

Jackie Lucht

Title

Operation Manager

Phone

(715) 842-3933

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1659863199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N 17TH AVE STE 200",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014225",
            "telephone_number": "608-519-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 WATERLOO AVE",
            "city": "WEST SALEM",
            "state": "WI",
            "postal_code": "546699270",
            "telephone_number": "608-519-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD SMILES OF WEST SALEM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "LUCHT",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "OPERATION MANAGER",
        "authorized_official_telephone_number": "715-842-3933"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Altman Mikshowsky, DNP, APRN
• Vicki S Miller
• Mississippi Valley Health Services Commission
• Mulder Health Care Facility, Inc
• Neighborhood Smiles of West Salem
• O2 Life LLC
• Orion West Salem LLC
• Alexandra Overturf, RN
• Paula Ann Parker
• Brittany Payne

• Dental Clinic/Center in West Salem, WI
• Providers in West Salem, 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 31, 2018; 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.