EDP OF WISCONSIN, SC (NPI# 1033671912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033671912 |
| Entity Type | Organization |
| Organization Name | EDP OF WISCONSIN, SC |
| Other Organization Name | DRS. LEAMAN, SETNICAR & PIACSEK |
| Practice Address |
820 Summit Ave Oconomowoc WI 53066-3973 |
| Mailing Address |
141 W Jackson Blvd Ste 210 Chicago IL 60604-3048 |
| Practice Telephone | 3128001270 |
| Mailing Telephone | 3129373619 |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2019-09-16 |
| Authorized Official Name | ROSEANNE BRUNENKANT (DIRECTOR OF INTEGRATIONS) |
| Authorized Official Telephone | 3129373619 |
| Is Organization Subpart | Y |
| Parent Organization Name | ELITE DENTAL PARTNERS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Drs. Leaman, Setnicar & Piacsek | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639685779 | Edp of Wisconsin, Sc | Clinic/Center | 600 Hartbrook Dr Stop 7, Hartland, WI 53029-1436 | 2017-12-27 |
| 1962961672 | Edp of Wisconsin, Sc | Clinic/Center | 141 W Jackson Blvd, Chicago, IL 60604-2992 | 2019-03-13 |
| Street Address |
820 SUMMIT AVE |
| City | OCONOMOWOC |
| State | WI |
| Zip Code | 53066-3973 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447211404 | Dale Alan Johnson | Family Medicine | 820 Summit Ave, Prohealth Care Medical Associates Fp, Oconomowoc, WI 53066-3973 | 2006-03-30 |
| 1386897965 | Prohealth Care Medical Associates Inc | Family Medicine | 820 Summit Ave, Oconomowoc, WI 53066-3900 | 2008-10-28 |
| 1225205255 | Kristen Ann Vento | Family Medicine | 820 Summit Ave, Prohealth Care Medical Associates, Oconomowoc, WI 53066-3900 | 2008-05-09 |
| 1306970264 | James S Leaman | Dentist | 820 Summit Ave, Oconomowoc, WI 53066-3920 | 2007-03-15 |
| 1093849804 | Joseph M Setnicar | Dentist | 820 Summit Ave, Oconomowoc, WI 53066-3920 | 2007-03-15 |
| 1366576159 | Stacie A Piacsek | Dentist | 820 Summit Ave, Oconomowoc, WI 53066-3920 | 2007-03-15 |
| 1952357212 | Drs. Leaman, Setnicar & Piacsek, S.c. | Dentist | 820 Summit Ave, Oconomowoc, WI 53066-3920 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376109082 | Sharon Legwinski | Occupational Therapist | 2195 N. Summit Way, Oconomowoc, WI 53066 | 2019-05-17 |
| 1033676390 | Paladina Health, LLC | Family Medicine | Paladina Health Oconomowoc Sentry Equipment Circle, 966 Blue Ribbon Circle N, Oconomowoc, WI 53066 | 2019-02-22 |
| 1689145500 | Oconomowoc Developmental Training Center of Wisconsin LLC | Residential Treatment Facility, Emotionally Disturbed Children | 36100 Genesee Lake School, Oconomowoc, WI 53066 | 2018-12-17 |
| 1649748203 | Ginny Dacquisto | Dietitian, Registered | 1134 Lily Rd, Oconomowoc, WI 53066 | 2018-11-12 |
| 1174000764 | Aimee M Metzger | Social Worker | 405 E Forest St Ste 113, Oconomowoc, WI 53066 | 2018-07-26 |
| 1023482569 | Forefront Dermatology, S.c. | Dermatology | 1320 Pabst Farms Cir, Suite 180, Oconomowoc, WI 53066 | 2015-11-20 |
| 1962890475 | Monica Rodriguez | Counselor | 405 East Forest Street, Suite 119, Oconomowoc, WI 53066 | 2015-01-06 |
| 1518384643 | Kimberley Bevan | Pharmacist | 1284 East Summit Avenue, Suite 100, Oconomowoc, WI 53066 | 2014-03-26 |
| 1699098905 | Heidi Eckroth Nunnemacher | Counselor | 35315 Genesee Lake Road, Oconomowoc, WI 53066 | 2010-03-02 |
| 1669705240 | Oconomowoc Development Training Center Ll | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3222 N. Silver Cedar Rd., Oconomowoc, WI 53066 | 2009-09-14 |
| Find all providers in zip 53066 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487868493 | Lake Country Dentistry, L.L.C. | Clinic/Center | 175 E Wisconsin Ave, Oconomowoc, WI 53066-3057 | 2007-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063907 | Osceola Family Dental, Ltd | Clinic/Center | 215 N Cascade St, Osceola, WI 54020 | 2020-11-03 |
| 1578173985 | Bright Dental and Braces LLC | Clinic/Center | 3046 Fish Hatchery Rd, Fitchburg, WI 53713-3125 | 2020-08-01 |
| 1609493188 | Willow Dental Group LLC | Clinic/Center | 3333 S Sunnyslope Rd Ste 100, New Berlin, WI 53151-4504 | 2020-06-30 |
| 1447875711 | Iola Family Dental, LLC | Clinic/Center | 100 Pine Crest Ln, Iola, WI 54945-8230 | 2020-06-12 |
| 1073135331 | Oasis Dental LLC | Clinic/Center | 1037 S Cesar E Chavez Dr, Milwaukee, WI 53204-2204 | 2020-05-09 |
| 1679116685 | Mdc Milwaukee, LLC | Clinic/Center | 4701 W National Ave, Milwaukee, WI 53214-3521 | 2019-10-22 |
| 1982263893 | Schmidt Dental Holdings LLC | Clinic/Center | 7430 W Forest Home Ave, Greenfield, WI 53220-3358 | 2019-06-13 |
| 1124580352 | Upper Lakes Dental, LLC | Clinic/Center | 908 E Main St Ste C, Winneconne, WI 54986-9672 | 2019-04-05 |
| 1356808067 | Julia Fosterarmstrong | Clinic/Center | 335 Vernal Ave, Milton, WI 53563-1248 | 2019-02-28 |
| 1366907032 | Dr John M Kane Sc | Clinic/Center | 10317 N Greenwood Ln, Hayward, WI 54843-7167 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
| City | OCONOMOWOC |
| Zip Code | 53066 |
Please comment or provide details below to improve the information on EDP OF WISCONSIN, SC.
| 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.