Crestview Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6410-15 Issued in WI

Legal business name

CRESTVIEW FAMILY DENTAL

Practice address

1810 Crest View Dr
Suite 5a
Hudson, WI 54016-9494

Phone

(715) 386-3727

NPI assigned

Sep 22, 2015

Last updated

Sep 22, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Lynn Mathys, DDS

Title

Dentist

Phone

(507) 250-0701

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, and the practitioner matching its NPPES authorized official.

• Paul Lawton, DDS

  • Dentist
  • Hudson, WI
  • NPI 1104023209
  NPD (past)

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1922477793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 CREST VIEW DR",
            "address_2": "SUITE 5A",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540169494",
            "telephone_number": "715-386-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 CREST VIEW DR",
            "address_2": "SUITE 5A",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540169494",
            "telephone_number": "715-386-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "MATHYS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "507-250-0701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6410-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie L Cortese, D.C.
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• Brian Crim, LMFT
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• Andrea Clair Cronk
• Amy M Crouch, RPH

• General Practice Dentistry in Hudson, WI
• Providers in Hudson, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.