DR. MARK R BOETTCHER (NPI# 1083826390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083826390 |
| Entity Type | Individual |
| Full Name | DR. MARK R BOETTCHER |
| Credential | DDS |
| Practice Address |
16905 West Wisconsin Ave Brookfield WI 53005-5729 |
| Practice Telephone | 2627544480 |
| Practice Fax Number | 2627544470 |
| Mailing Telephone | 2627544480 |
| Mailing Fax Number | 2627544470 |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5001903015 | WI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33363900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750325155 | Mark C Boettcher | Pediatrics | 3200 E Racine St, Janesville, WI 53546-2343 | 2006-06-15 |
| Street Address |
16905 WEST WISCONSIN AVE |
| City | BROOKFIELD |
| State | WI |
| Zip Code | 53005-5729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154937621 | Nsk Precision Healing & Wellness | Acupuncturist | 17040 W. Greenfield Ave #6, Brookfield, WI 53005 | 2020-09-21 |
| 1033772124 | Dbt Consultants LLC | Social Worker | 200 S. Executive Drive, Ste. 101, Brookfield, WI 53005 | 2019-04-15 |
| 1780142588 | Ashley Wing | Registered Nurse | 405 Bishops Way, Apt 555, Brookfield, WI 53005 | 2019-03-11 |
| 1407370398 | Tombolo, LLC | Clinic/Center | 12545 W. Burleigh Rd., Suite 10, Brookfield, WI 53005 | 2017-08-01 |
| 1720509045 | Rss William Conner LLC | Dentist | 15455 W Bluemound Rd Ste 250, Brookfield, WI 53005 | 2017-06-28 |
| 1669926598 | Mackenzie Rondeau | Physical Therapist | 1905 N Calhoun Rd Ste 105, Brookfield, WI 53005 | 2016-08-09 |
| 1699159319 | Charles Alan Kass | Dentist | 12720 W. North Avenue, Brookfield, WI 53005 | 2015-07-13 |
| 1164804274 | Mary-catherine Nimphius | Counselor | 250 S. Sunny Slope Rd, #128, Brookfield, WI 53005 | 2015-06-25 |
| 1528447034 | Weighless Md, LLC | Dietitian, Registered | 14960 W. Greenfield Ave Suite 104, Brookfield, WI 53005 | 2015-05-29 |
| 1366837346 | Maegan Michelle Cook | Dentist | 13780 W Greenfield Ave Ste 780, Brookfield, WI 53005 | 2015-04-06 |
| Find all providers in zip 53005 | ||||
| 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 |
|---|---|---|---|---|
| 1700428216 | Binninger Dentistry, LLC | Dentist | 12720 W North Ave Bldg B, Brookfield, WI 53005-4637 | 2019-10-16 |
| 1831677244 | Euiyoung Chong | Dentist | 17160 W North Ave Ste 101, Brookfield, WI 53005-4437 | 2018-07-30 |
| 1720509045 | Rss William Conner LLC | Dentist | 15455 W Bluemound Rd Ste 250, Brookfield, WI 53005 | 2017-06-28 |
| 1710432901 | Emily Baker | Dentist | 12780 W North Ave Ste A, Brookfield, WI 53005-4601 | 2016-08-17 |
| 1316326093 | Zahra Al Rawi | Dentist | 115 S Moorland, Brookfield, WI 53005-4230 | 2015-05-27 |
| 1366837346 | Maegan Michelle Cook | Dentist | 13780 W Greenfield Ave Ste 780, Brookfield, WI 53005 | 2015-04-06 |
| 1780930156 | Harry W Zirgibel Jr. | Dentist | 1700 W Capitol Dr., Brookfield, WI 53005 | 2012-08-03 |
| 1568720613 | Christopher Vijay Soares | Dentist | 128 Candlewood Lake Rd, Brookfield, CT 06804-2226 | 2012-04-26 |
| 1093914772 | David Brilowski | Dentist | 17000 W North Ave Ste 104e, Brookfield, WI 53005-4423 | 2007-07-13 |
| 1386867679 | Thomas T Tang | Dentist | 17185 W North Ave, Brookfield, WI 53005-4428 | 2007-04-11 |
| Find all providers in BROOKFIELD | ||||
| City | BROOKFIELD |
| Zip Code | 53005 |
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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.