Willow Cove Dental, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5396-15 Issued in WI

Legal business name

WILLOW COVE DENTAL, LLC

Practice address

1195 W Mason St
Green Bay, WI 54303-2045

Phone

(920) 235-3251

NPI assigned

Sep 28, 2017

Organization subpart

No

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

Authorized official

Name

Wyn Steckbauer, DMDNPI 1841391109

Title

Owner

Phone

(920) 235-3251

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.

• Wyn Steckbauer, D.M.D.

  • Dentist
  • Oshkosh, WI
  • NPI 1841391109
  NPD Authorized official

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1801305271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WITZEL AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549041700",
            "telephone_number": "920-235-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032045",
            "telephone_number": "920-235-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW COVE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-28",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "STECKBAUER",
        "authorized_official_first_name": "WYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-235-3251",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WI",
            "license": "5396-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanie L Williams, PT
• Victoria Ann Williams, PTA
• Ezra Brandon Williamson I, LPC
• Angelica Shekirra Willis, ADULT FAMILY HOME
• Marlo Ahn Willman, SLP
• Austin Robert Wills, MD
• Amanda Wilson, PHARMD
• Ashley Lynn Wilson, DPT
• Bernadette L Wilson, DDS MD
• Danielle M Wilson, PT

• Dental Clinic/Center in Green Bay, WI
• Providers in Green Bay, 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 Oct 18, 2023; 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.