Endodontic Specialists of Lacrosse LTD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

ENDODONTIC SPECIALISTS OF LACROSSE LTD

Practice address

2700 National Dr
Ste 102
Onalaska, WI 54650

Phone

(608) 783-3636

Fax

(608) 783-3639

NPI assigned

Aug 2, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Derek B Nordeen, DDSNPI 1467890475

Title

President of Corporation

Phone

(608) 783-3636

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Derek B Nordeen, DDS

  • Endodontics
  • Onalaska, WI
  • NPI 1467890475
  NPD (past) Authorized official
• Daniel Young, DMD

  • Endodontics
  • Onalaska, WI
  • NPI 1083870232
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1972504843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 NATIONAL DR",
            "address_2": "STE 102",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "54650",
            "telephone_number": "608-783-3636",
            "fax_number": "608-783-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 NATIONAL DR",
            "address_2": "STE 102",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "54650",
            "telephone_number": "608-783-3636",
            "fax_number": "608-783-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTIC SPECIALISTS OF LACROSSE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NORDEEN",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "608-783-3636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Michael Earll, DDS
• Margaret J Ebert, NP
• Markus A Eckstein
• Eclectic Counseling
• Janis Lorraine Elder, LPC
• Katherine Eppolito, DMD
• Ivy L Erickson, PA-C
• Jacob L Erickson, DO
• Joel D Erickson, MD
• Mary C. Erickson, RPH

• Endodontics in Onalaska, WI
• Providers in Onalaska, WI by specialty
• Endodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.