Individual provider Active NPI

Michael Allan Lamarca, D.D.S.

  • General Practice Dentistry
  • Green Bay, WI
National Provider Identifier
1689795957
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5598-15 Issued in WI
Practice address
424 S Monroe Ave
Green Bay, WI 54301-4054
Phone
(920) 437-7206
Fax
(920) 437-0984
NPI assigned
Apr 3, 2007
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-026371 IL
General Practice Dentistry 1223G0001X 5598-15 WI Primary

Addresses

Primary practice location

424 S Monroe Ave
Green Bay, WI 54301-4054

Mailing address

622 Bodart St
Green Bay, WI 54301-4923
Phone (920) 940-8034

Other practice location 1

2740 W Mason St
Green Bay, WI 54303-4966
Phone (920) 437-7206

Other practice location 2

228 S 18th Ave
Sturgeon Bay, WI 54235-1000
Phone (920) 437-7206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019-026371ILMDGeneral Practice Dentistry
5598-15WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
N.E.W. Community Clinic, LTD CurrentSince Aug 17, 2025 Accepting new patients
Poldek Family Dental Past Accepting new patients

Locations

2740 W Mason St
Green Bay, WI 54303
Phone (920) 437-7206

424 S Monroe Ave
Green Bay, WI 54301
Phone (920) 437-7206

622 Bodart St
Green Bay, WI 54301
Phone (920) 437-7206

Interoperability endpoints

  • Direct secure messaging: mlamarca891772@direct.emplifyhealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1689795957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 BODART ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014923",
            "telephone_number": "920-940-8034",
            "fax_number": "920-437-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 S MONROE AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014054",
            "telephone_number": "920-437-7206",
            "fax_number": "920-437-0984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2740 W Mason St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543034966",
            "country_code": "US",
            "telephone_number": "920-437-7206",
            "fax_number": "920-437-0984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "228 S 18th Ave",
            "address_purpose": "LOCATION",
            "city": "Sturgeon Bay",
            "state": "WI",
            "postal_code": "542351000",
            "country_code": "US",
            "telephone_number": "920-437-7206",
            "fax_number": "920-437-0984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAMARCA",
        "first_name": "MICHAEL",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-026371",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5598-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.