Green Bay Family Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

License

4264 Issued in WI

Legal business name

GREEN BAY FAMILY DENTAL LLC

Practice address

2609 Development Dr.
Green Bay, WI 54311

Phone

(920) 432-2961

NPI assigned

Aug 3, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Heidi Eggers-Ulve, DDS, MSNPI 1235161514

Title

Member

Phone

(920) 432-2961

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.

• Heidi Eggers-Ulve, D.D.S., M.S.

  • Pediatric Dentistry
  • Green Bay, WI
  • NPI 1235161514
  NPD (past) Authorized official

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1851844161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 DEVELOPMENT DR.",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-432-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 DEVELOPMENT DR.",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-432-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN BAY FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-03",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "EGGERS-ULVE",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "920-432-2961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "4264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Green Bay Emergency Physicians, LLC
• Green Bay Heartcare S.C.
• Green Bay II Al Operations LLC
• Green Bay Oncology, LTD
• Green Bay Orthopedics Limited
• Green Bay Pediatric Therapy, LLC

• Dentist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.