UPPER LAKES DENTAL, LLC


Address: 908 E Main St Ste C, Winneconne, WI 54986-9672
Phone: 9205820688

UPPER LAKES DENTAL, LLC (NPI# 1124580352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124580352
Entity Type Organization
Organization Name UPPER LAKES DENTAL, LLC
Practice Address 908 E Main St Ste C
Winneconne
WI 54986-9672
Mailing Address Po Box 369
Winneconne
WI 54986-0369
Practice Telephone 9205820688
Mailing Telephone 9205820688
Enumeration Date 2019-04-05
Last Update Date 2019-04-05
Authorized Official Name DR. RYAN GONZALEZ (OWNER)
Authorized Official Telephone 9205820688
Authorized Official Credential D.D.S.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
Ambulatory Health Care Facilities

Office Location

Street Address 908 E MAIN ST STE C
City WINNECONNE
State WI
Zip Code 54986-9672

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1346658903 Winneconne Chiropractic and Sports Rehab LLC Chiropractor 238 W Main Street, Winneconne, WI 54986 2014-07-28
1588770671 Timothy Owen Mcginnis Chiropractor 11 N 6th Ave, Winneconne, WI 54986 2006-08-22
1972942175 Kimberly Ann Lewis Counselor 140 W Main Street, The Growing Tree, Winneconne, WI 54986 2013-06-20
1619278819 Alexandra Kellogg Chiropractor 238 W Main St, Winneconne, WI 54986 2010-11-04
1013174465 Ascension Medical Group-fox Valley Wisconsin, Inc Clinic/Center 916 E Main St, Winneconne, WI 54986 2008-05-21
1326242496 Aurora Medical Group, Inc. Durable Medical Equipment & Medical Supplies 6085 Harbour View Dr, Winneconne, WI 54986-8656 2007-06-13
1295262772 Evelyn Lauren Andersen Registered Nurse 6085 Harbour View Dr, Winneconne, WI 54986-8656 2017-05-16
1336772730 Luke William Berglund Student in an Organized Health Care Education/Training Program 1132 Aster Ln, Winneconne, WI 54986-9166 2020-02-14
1376817163 Shopko Stores Operating Co LLC Durable Medical Equipment & Medical Supplies 946 E Main St., Winneconne, WI 54986-9396 2012-02-27
1144531757 The Growing Tree Counseling & Wellness Counselor 140 W Main St Ste A, Winneconne, WI 54986-9409 2010-06-29
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Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

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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
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
1518422880 Bright Dental Madison LLC Clinic/Center 7866 Mineral Point Rd, Madison, WI 53717-2028 2019-01-31
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Competitor

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City WINNECONNE
Zip Code 54986

Improve Information

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Dataset Information

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.

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