PRESCOTT FAMILY DENTAL (NPI# 1093113789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093113789 |
Entity Type | Organization |
Organization Name | PRESCOTT FAMILY DENTAL |
Practice Address |
1015 Campbell St N Prescott WI 54021-1157 |
Practice Telephone | 7152623382 |
Practice Fax Number | 7152623063 |
Mailing Telephone | 7152623382 |
Mailing Fax Number | 7152623063 |
Enumeration Date | 2014-12-11 |
Last Update Date | 2018-03-08 |
Authorized Official Name | CASSIE LYNN ERICKSON (OFFICE MANAGER) |
Authorized Official Telephone | 7152623382 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223G0001X |
Dentist Specialization: General Practice |
3523 | WI | Dental Providers |
Y | 1223G0001X |
Dentist Specialization: General Practice |
6932 | WI | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 33478900 | 05 | |
WI | 100024073 | 05 |
Street Address |
1015 CAMPBELL ST N |
City | PRESCOTT |
State | WI |
Zip Code | 54021-1157 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144320193 | Michael Joseph Toninato | Dentist | 1015 Campbell St N, Prescott, WI 54021-1157 | 2006-09-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922104801 | Gerald Otto Gatzke | Dentist | 127 Broad St N, Prescott, WI 54021-0000 | 2006-09-16 |
1336328038 | School District of Prescott | Local Education Agency (LEA) | 1220 Saint Croix St, Prescott, WI 54021-1042 | 2007-10-30 |
1336407386 | Hillary Jane Hunter | Dentist | 1267 Walnut St, Prescott, WI 54021-1060 | 2012-04-27 |
1922090521 | Ccg Prescott, Inc | Skilled Nursing Facility | 1505 Orrin Rd, Prescott, WI 54021-1074 | 2005-08-19 |
1467051714 | Rebekah Kimlinger | Physical Therapist | 1505 Orrin Rd, Prescott, WI 54021-1074 | 2020-10-19 |
1548886278 | Sara Michele Jenkins | Occupational Therapy Assistant | 1505 Orrin Rd, Prescott, WI 54021-1074 | 2020-06-18 |
1245700624 | Caitlin Ann Johnson | Occupational Therapy Assistant | 1505 Orrin Rd, Prescott, WI 54021-1074 | 2018-11-28 |
1164991980 | Sarah Hei | Occupational Therapist | 1505 Orrin Rd, Prescott, WI 54021-1074 | 2018-11-21 |
1861960791 | Janna M Johnson | Physical Therapist | 1505 Orrin Rd, Prescott, WI 54021-1074 | 2018-11-08 |
1124528393 | Morgan Lee Williamson | Occupational Therapy Assistant | 1505 Orrin Rd, Prescott, WI 54021-1074 | 2018-02-14 |
Find all providers in zip 54021 |
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 |
---|---|---|---|---|
1730664475 | Smiles of Arkansas Dental Center, Pllc | Dentist | 1495 W 1st St N, Prescott, AR 71857-3340 | 2018-09-28 |
1861985566 | Joshua Michael Allen | Dentist | 815 Gail Gardner Way Ste B, Prescott, AZ 86305-1800 | 2018-06-07 |
1790159853 | Michele A. Bibeau, D.d.s. | Dentist | 1058 Fair Street, Suite A, Prescott, AZ 86305 | 2015-11-30 |
1902245434 | Tori Balbos | Dentist | 3765 Crossings Dr, Suite A, Prescott, AZ 86305-7121 | 2013-06-18 |
1336407386 | Hillary Jane Hunter | Dentist | 1267 Walnut St, Prescott, WI 54021-1060 | 2012-04-27 |
1255564506 | An Elegant Smile P.C. | Dentist | 980 Willow Creek Rd Ste 103, Prescott, AZ 86301-1619 | 2009-09-02 |
1083880082 | Mark Hayden | Dentist | 350 Whipple St, Prescott, AZ 86301-1714 | 2008-04-30 |
1073791919 | Keith L Rosdahl | Dentist | 1959 Commerce Center Cir., Prescott, AZ 86301 | 2008-02-02 |
1053517185 | Michele A Bibeau | Dentist | 1058 Fair St Ste A, Prescott, AZ 86305-1803 | 2007-06-25 |
1558564997 | Gene Allen | Dentist | 680 Gail Gardner Way, Prescott, AZ 86305-2335 | 2007-06-05 |
Find all providers in PRESCOTT |
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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.