Premier Periodontics LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

5001847-15 Issued in WI

Legal business name

PREMIER PERIODONTICS LLC

Practice address

2933 W Layton Ave
Greenfield, WI 53221-2626

Phone

(414) 282-2642

Fax

(414) 282-1952

NPI assigned

Oct 24, 2013

Organization subpart

Yes

Parent organization

STEPPING STONE DENTAL PARTNERS LLCAs reported in NPPES

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

Authorized official

Name

Genevieve E Poppe

Title

Partner

Phone

(608) 358-3370

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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

• Eddie Morales, DDS

  • Periodontics
  • Greenfield, WI
  • NPI 1265743488
  NPD (past)
• Constantine Stamatelakys, DDS

  • Periodontics
  • Greenfield, WI
  • NPI 1235132192
  NPD (past)

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382572800000",
    "number": "1770911976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212626",
            "telephone_number": "414-282-2642",
            "fax_number": "414-282-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212626",
            "telephone_number": "414-282-2642",
            "fax_number": "414-282-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PERIODONTICS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STEPPING STONE DENTAL PARTNERS LLC",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-10-24",
        "status": "A",
        "authorized_official_last_name": "POPPE",
        "authorized_official_first_name": "GENEVIEVE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "608-358-3370"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "WI",
            "license": "5001847-15",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "WI",
            "license": "7160-15",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Post Acute Specialty Hospital of Milwaukee LLC (PAM Specialty Hospital of Milwaukee)
• Kinga Postolowicz
• Marica Potkonjak
• Isaac A Pratzel
• Preferred Rehabilitation and Orthopedic Care Center S.C.
• Pauline Ann Preuss, MA
• Kimberly Ann Pritchard, LPC, NCC
• Progressive Periodonitics and Dental Implants
• Richard Eward Protasiewicz Jr., D.C.
• Patrick Quane, HCP

• Periodontics in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Periodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.