NPIMap

Organization Active NPI

Cherry Tree Dental, LLC

  • General Practice Dentistry
  • Wausau, WI
National Provider Identifier
1861547754
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5000305 Issued in WI
Legal business name
CHERRY TREE DENTAL, LLC
Practice address
2800 Westhill Dr
S-104
Wausau, WI 54401-3771
Phone
(715) 843-5709
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Authorized official

Name
Mrs. Ericka Taylor
Title
Director of HR
Phone
(608) 833-4814

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 5000305 WI Primary

Addresses

Primary practice location

2800 Westhill Dr
S-104
Wausau, WI 54401-3771

Mailing address

8025 Excelsior Dr
Madison, WI 53717
Phone (608) 833-2212

National Provider Directory

National Provider Directory

Locations

2800 Westhill Dr
#S104
Wausau, WI 54401
Phone (715) 843-5709

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433116800000",
    "number": "1861547754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 EXCELSIOR DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53717",
            "telephone_number": "608-833-2212",
            "fax_number": "608-833-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 WESTHILL DR",
            "address_2": "S-104",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013771",
            "telephone_number": "715-843-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY TREE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2015-06-01",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "ERICKA",
        "authorized_official_title_or_position": "DIRECTOR OF HR",
        "authorized_official_telephone_number": "608-833-4814",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5000305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.