Organization Active NPI

Neider & Knoell Dental S.C.

  • General Practice Dentistry
  • Racine, WI
National Provider Identifier
1689635203
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5000934 Issued in WI
Legal business name
NEIDER & KNOELL DENTAL S.C.
Practice address
5707 Byrd Ave
Racine, WI 53406-4746
Phone
(262) 637-7276
Fax
(262) 637-7633
NPI assigned
Mar 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Cindy A Wilson
Title
Office Manager
Phone
(262) 637-7276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5000934 WI Primary

Addresses

Primary practice location

5707 Byrd Ave
Racine, WI 53406-4746

Mailing address

5707 Byrd Ave
Racine, WI 53406-4746
Phone (262) 637-7276

National Provider Directory

National Provider Directory

Locations

5707 Byrd Ave
Racine, WI 53406
Phone (262) 637-7276

Practitioners & affiliated clinicians

Practitioners 3

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": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689635203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 BYRD AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064746",
            "telephone_number": "262-637-7276",
            "fax_number": "262-637-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 BYRD AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064746",
            "telephone_number": "262-637-7276",
            "fax_number": "262-637-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIDER & KNOELL DENTAL S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "262-637-7276",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5000934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • 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.