DR. SHOBA WARREN (NPI# 1023165560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023165560 |
| Entity Type | Individual |
| Full Name | DR. SHOBA WARREN |
| Practice Address |
6218 Washington Ave Suite C Racine WI 53406-3916 |
| Practice Telephone | 2628861300 |
| Practice Fax Number | 2628861837 |
| Mailing Telephone | 2628861300 |
| Mailing Fax Number | 2628861837 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
4439 | WI | Dental Providers |
| Street Address |
6218 WASHINGTON AVE SUITE C |
| City | RACINE |
| State | WI |
| Zip Code | 53406-3916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275699738 | Lisa Gabrius Fortunato | Dentist | 6218 Washington Ave, Suite C, Racine, WI 53406-3916 | 2006-12-29 |
| 1548390594 | Robert L. Heller Jr. | Dentist | 6218 Washington Ave, Racine, WI 53406-3916 | 2007-03-07 |
| 1023148301 | Wisconsin Dental Group,s.c. | Dentist | 6218 Washington Ave, Suite C, Racine, WI 53406-3916 | 2007-03-06 |
| 1376690743 | Timothy Eugene Okland | Chiropractor | 6218 Washington Ave, Ste A, Racine, WI 53406 | 2007-01-05 |
| 1710044243 | Jeffrey Romanski | Dentist | 6218 Washington Ave, Suite C, Racine, WI 53406-3916 | 2007-01-03 |
| 1417014572 | Poornima Jayaprakash | Dentist | 6218 Washington Ave, Suite C, Racine, WI 53406-3916 | 2007-01-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
| 1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
| 1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
| 1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| Find all providers in zip 53406 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275873374 | F Kris Olsen | Dentist | 1320 S Green Bay Road, Racine Dental Group, Racine, WI 53406 | 2013-02-26 |
| 1366572927 | Wisconsin Dental Group, S.c. | Dentist | 6218 Washington Ave Ste C, Racine, WI 53406-3916 | 2007-03-06 |
| 1366546996 | Gregory T Isermann Dds Ms Sc | Dentist | 3500 Meachem Road, Racine, WI 53405-4662 | 2006-09-12 |
| 1821150418 | Gregory T Isermann | Dentist | 3500 Meachem Rd, Racine, WI 53405-4662 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
| 1891319273 | Janesville Endodontics | Dentist | 1616 N Randall Ave Ste 180, Janesville, WI 53545-1155 | 2020-06-02 |
| 1306480918 | Teng Kai Ong | Dentist | 1801 West Wisconsin Ave., Milwaukee, WI 53233 | 2019-11-06 |
| 1215344478 | Helen Tsao | Dentist | 2606 Stewart Ave, Ste 102, Wausau, WI 54401-5502 | 2014-07-18 |
| 1275973166 | Meridian Endodontics and Periodontics | Dentist | 20350 Water Tower Blvd Ste 203, Brookfield, WI 53045-3558 | 2013-06-25 |
| 1447698451 | Eva C Dahl | Dentist | 2700 National Dr Ste 1, Onalaska, WI 54650-6708 | 2013-06-12 |
| 1063710655 | Erik Daniel Deyoung | Dentist | 6100 W State St, Apt. 636, Wauwatosa, WI 53213-2983 | 2011-03-05 |
| 1376786285 | Ronald David Meyers | Dentist | 2600 N Mayfair Rd Ste 240, Wauwatosa, WI 53226-1309 | 2009-04-08 |
| 1942450457 | Wisconsin Endodontic Group, S.c. | Dentist | 2600 N. Mayfair Rd., Ste 240, Wauwatosa, WI 53226 | 2008-09-22 |
| 1558519058 | Kendra Kay Boda | Dentist | 3004 Golf Rd Ste 102, Eau Claire, WI 54701-8794 | 2008-09-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.