PARC VILLAGE DENTAL, LLC (NPI# 1386102465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386102465 |
| Entity Type | Organization |
| Organization Name | PARC VILLAGE DENTAL, LLC |
| Practice Address |
2805 Libal Street, Suite A Green Bay WI 54301 |
| Practice Telephone | 9203366062 |
| Practice Fax Number | 9203369272 |
| Mailing Telephone | 9203366062 |
| Mailing Fax Number | 9203369272 |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2019-03-07 |
| Authorized Official Name | STEVEN R HEIN (MEMBER) |
| Authorized Official Telephone | 9203366062 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | PARC VILLAGE DENTAL, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
2805 LIBAL STREET, SUITE A |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| 1164869038 | Jean Marie Richardson | Pharmacist | 3030 Grande Rue, Green Bay, WI 54301 | 2013-05-31 |
| Find all providers in zip 54301 | ||||
| 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 |
| 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 |
| 1063622645 | Echo Ridge Dental Clinic | Dentist | 2140 S. Ridge Rd., Green Bay, WI 54304 | 2007-05-23 |
| 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.