Northstar Dental GRP

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

NORTHSTAR DENTAL GRP

Practice address

5760 Grande Market Dr
Appleton, WI 54913

Phone

(920) 997-1557

Fax

(920) 997-0688

NPI assigned

Jan 20, 2006

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

Dr. Peter D Hehli, DDSNPI 1144349580

Title

Owner Dentist

Phone

(920) 997-1557

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, and the practitioner matching its NPPES authorized official.

• Peter D Hehli, DDS

  • Dentist
  • Appleton, WI
  • NPI 1144349580
  NPD (past) Authorized official

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679553093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5760 GRAND MARKET DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54913",
            "telephone_number": "920-997-1557",
            "fax_number": "920-997-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5760 GRANDE MARKET DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54913",
            "telephone_number": "920-997-1557",
            "fax_number": "920-997-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR DENTAL GRP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEHLI",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "920-997-1557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Appleton, WI
• Providers in Appleton, WI by specialty
• Dentist 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.