NPIMap

Organization Active NPI

Mosinee Family Dental LLC

  • Dentist
  • Mosinee, WI
National Provider Identifier
1982143574
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5542-15 Issued in WI
Legal business name
MOSINEE FAMILY DENTAL LLC
Practice address
435 Orbiting Dr Ste a
Mosinee, WI 54455-1762
Phone
(715) 693-4530
NPI assigned
Feb 16, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Authorized official

Name
Leah Bouton
Title
Office Manager
Phone
(715) 693-4530

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 5542-15 WI Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 5001639-15 WI

Addresses

Primary practice location

435 Orbiting Dr Ste a
Mosinee, WI 54455-1762

Mailing address

435 Orbiting Dr Ste a
Mosinee, WI 54455-1762
Phone (715) 693-4530

National Provider Directory

National Provider Directory

Locations

435 Orbiting Dr
#A
Mosinee, WI 54455
Phone (715) 693-4530

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": "1487203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1982143574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 ORBITING DR STE A",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544551762",
            "telephone_number": "715-693-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 ORBITING DR STE A",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544551762",
            "telephone_number": "715-693-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSINEE FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-16",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "BOUTON",
        "authorized_official_first_name": "LEAH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "715-693-4530"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "5542-15",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "5001639-15",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mosinee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.