Lifetime Family Dentistry of Two Rivers

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3639015 Issued in WI

Legal business name

LIFETIME FAMILY DENTISTRY OF TWO RIVERS

Practice address

1509 19TH St
Two Rivers, WI 54241-2628

Phone

(920) 794-8947

Fax

(920) 793-8463

NPI assigned

Apr 6, 2011

Last updated

Apr 6, 2011By 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

Mr. Timothy Buck

Title

Owner

Phone

(608) 220-1168

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.

• Jamie Lee Meunier, DMD

  • Dentist
  • Two Rivers, WI
  • NPI 1023594744
  NPD (past)

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1972892214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 19TH ST",
            "city": "TWO RIVERS",
            "state": "WI",
            "postal_code": "542412628",
            "telephone_number": "920-794-8947",
            "fax_number": "920-793-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 19TH ST",
            "city": "TWO RIVERS",
            "state": "WI",
            "postal_code": "542412628",
            "telephone_number": "920-794-8947",
            "fax_number": "920-793-8463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME FAMILY DENTISTRY OF TWO RIVERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-06",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-220-1168",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3639015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josey R Laughlin, CRNA
• Cynthia L Lecloux, A.P.N.P
• Brett J Leiknes, MD
• Dane Leist, PHARMD
• Bryce Alexandra Lewellen, O.D.
• Alexis Lindstrom, DOCTOR OF PT
• Kelly A. Litersky, MS, RD, CD
• Monique M Litersky, LCSW
• Nicholas W Lockhart, PT
• Caline Daun Long, PA

• General Practice Dentistry in Two Rivers, WI
• Providers in Two Rivers, 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 Apr 6, 2011; 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.