NPIMap

Organization Active NPI

Sunridge Dental LLC

  • Dentist
  • Green Bay, WI
National Provider Identifier
1891172425
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6367 Issued in WI
Legal business name
SUNRIDGE DENTAL LLC
Practice address
2926 Finger Rd
Green Bay, WI 54311-7548
Phone
(920) 468-8085
NPI assigned
May 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Authorized official

Name
Dr. Jill M Carter, D.D.S.NPI 1346302916
Title
Owner
Phone
(920) 468-8085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6367 WI Primary

Addresses

Primary practice location

2926 Finger Rd
Green Bay, WI 54311-7548

Mailing address

2926 Finger Rd
Green Bay, WI 54311-7548
Phone (920) 468-8085

Other names 1

  • Jill M Carter, DDS Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1891172425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2926 FINGER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543117548",
            "telephone_number": "920-468-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2926 FINGER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543117548",
            "telephone_number": "920-468-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRIDGE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-468-8085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "6367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jill M Carter, DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 May 4, 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.