ECHO RIDGE DENTAL CLINIC (NPI# 1063622645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063622645 |
| Entity Type | Organization |
| Organization Name | ECHO RIDGE DENTAL CLINIC |
| Practice Address |
2140 S. Ridge Rd. Green Bay WI 54304 |
| Practice Telephone | 9204947464 |
| Practice Fax Number | 9204947919 |
| Mailing Telephone | 9204947464 |
| Mailing Fax Number | 9204947919 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RAYMOND L SCHNEIDER III (OWNER-DENTIST) |
| Authorized Official Telephone | 92049474646 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
WI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861848293 | Echo Ridge Dental Clinic | Clinic/Center | 2140 S Ridge Rd, Green Bay, WI 54304-4357 | 2016-05-04 |
| Street Address |
2140 S. RIDGE RD. |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689196255 | Kristen Ashley Haltom | Registered Nurse | 2979 Allied St Suite C, Green Bay, WI 54304 | 2017-07-14 |
| 1649671421 | Heather Marie Novak | Counselor | 2979 Allied St Unit C, Green Bay, WI 54304 | 2014-09-11 |
| 1356777684 | Nathan Weir | Specialist/Technologist | 1265 Lombardi Avenue, Green Bay, WI 54304 | 2013-09-18 |
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1447551379 | Citralina M Haruo | Community Health Worker | 1110 11th Avenue, Green Bay, WI 54304 | 2010-11-09 |
| 1497061352 | Daniel James Gustin | Pharmacist | 1109 Lombardi Ave, Green Bay, WI 54304 | 2010-08-28 |
| 1316259898 | Karen A Detrick | Occupational Therapy Assistant | 1040 Pilgram Way, Woodside Senior Communities, Green Bay, WI 54304 | 2010-07-13 |
| 1861667362 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 2605 S. Oneida St. Suite 107, Green Bay, WI 54304 | 2008-04-25 |
| 1891967303 | Kimberley M Welk | Marriage & Family Therapist | 926 Willard Dr Ste 136, Green Bay, WI 54304 | 2008-03-25 |
| 1750563698 | Richard Lawrence Beyer | Hearing Instrument Specialist | 2154 S Ridge Rd, Green Bay, WI 54304 | 2007-12-03 |
| Find all providers in zip 54304 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124670898 | Robert H Wagner Family Dentist S.c. | Dentist | 2830 Curry Court, Suite 1, Green Bay, WI 54311 | 2019-07-12 |
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1578052866 | Matthew Robert Wagner | Dentist | 2830 Curry Ln #1, Green Bay, WI 54311 | 2018-05-02 |
| 1588197149 | Familia Dental West Green Bay | Dentist | 2280 W Mason St, Green Bay, WI 54303-4707 | 2017-04-10 |
| 1225489974 | Nicholas Van Ess | Dentist | 1640 Main St Stop 1, Green Bay, WI 54302-2639 | 2016-06-23 |
| 1063822328 | Jessica Leigh Pasono | Dentist | 2609 Development Dr, Green Bay, WI 54311 | 2014-05-07 |
| 1710191085 | Lisa Rachel Piontek | Dentist | 526 S Monroe Ave, Green Bay, WI 54301-4018 | 2007-05-09 |
| 1831301290 | Family Dental Center of Green Bay, S.c. | Dentist | 2247 Fox Heights Ln, Green Bay, WI 54304-4747 | 2007-05-05 |
| 1194946079 | Kirk Richard Fishbaugh | Dentist | 2625 Tulip Ln, Green Bay, WI 54313-6855 | 2007-05-01 |
| 1649493529 | Michael J Pierquet Dds Sc | Dentist | 2140 Velp Ave, Green Bay, WI 54303-6492 | 2007-04-10 |
| Find all providers in GREEN BAY | ||||
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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.