ADVANCED DENTAL CARE CLINIC SC (NPI# 1396258752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396258752 |
| Entity Type | Organization |
| Organization Name | ADVANCED DENTAL CARE CLINIC SC |
| Practice Address |
62 S Pleasant View Road Plymouth WI 53073 |
| Mailing Address |
62 S Pleasant View Rd Plymouth WI 53073-4954 |
| Practice Telephone | 9208928466 |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2019-12-13 |
| Authorized Official Name | HOOMAN SERESHKI (OWNER) |
| Authorized Official Telephone | 9208928466 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
62 S PLEASANT VIEW ROAD |
| City | PLYMOUTH |
| State | WI |
| Zip Code | 53073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245889914 | Patricia M. Stone | Technician | 440 Stoneybrook Lane, Plymouth, WI 53073 | 2019-09-05 |
| 1801387501 | Kwon Yang | Dentist | W 9071 Forest Drive, Plymouth, WI 53073 | 2018-05-29 |
| 1164888004 | Lukresse Tatiana Kouam Tchuendem | Registered Nurse | 236 N Milwaukee St, Plymoth, WI 53073 | 2016-01-07 |
| 1831447424 | Lori Ann Schuette | Registered Nurse | 406 Summit Street, Plymouth, WI 53073 | 2012-08-29 |
| 1821360967 | Kristine Marie Van Ess | Case Manager/Care Coordinator | 7135 Rocky Knoll Pkwy, Plymouth, WI 53073 | 2012-02-06 |
| 1750699708 | Shannon Diamond | Physical Therapist | 825 Walton Drive, Plymouth, WI 53073 | 2010-09-23 |
| 1306088265 | Lacey Lyn Schafer | Nurse Practitioner | W9071 Forest Dr, Plymouth, WI 53073 | 2009-03-24 |
| 1275780868 | Stella D. Kaas-lallensack | Occupational Therapist | W5774 Garton Rd, Plymouth, WI 53073 | 2008-08-26 |
| 1912172248 | Judith A Nelson | Registered Nurse | N7116 County Road E, Plymouth, WI 53073 | 2008-04-28 |
| 1740489509 | Tammy Marie Thill | Social Worker | 1111 Reed Street, Plymouth, WI 53073 | 2007-07-12 |
| Find all providers in zip 53073 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952918781 | Asp Dental, PC | Clinic/Center | 9800 Shelard Pkwy Ste 130, Plymouth, MN 55441-6451 | 2020-09-25 |
| 1326670886 | Plymouth Ardent | Clinic/Center | 40400 Ann Arbor Rd E Ste 103, Plymouth, MI 48170-4590 | 2020-02-12 |
| 1427695063 | Beacon Dental Health PC | Clinic/Center | 1 Scobee Cir # 2a, Plymouth, MA 02360-4887 | 2019-12-03 |
| 1952965949 | Minnesota Sleep and Wellness LLC | Clinic/Center | 15600 36th Ave N Ste 270a, Plymouth, MN 55446-3369 | 2019-04-25 |
| 1134611122 | Chad W. Barber, Dds, PC | Clinic/Center | 9331 N Lilley Rd, Plymouth, MI 48170-4609 | 2018-06-05 |
| 1194215616 | Four Seasons Dental Pa | Clinic/Center | 4205 Lancaster Ln N Ste 101, Plymouth, MN 55441-1702 | 2018-05-10 |
| 1053834481 | Mondale Dental | Clinic/Center | 10600 Old County Road 15 Ste 120, Plymouth, MN 55441-6205 | 2017-07-18 |
| 1902060213 | Thomas F. Rogers, D.d.s., P.C. | Clinic/Center | 141 Court St, Plymouth, MA 02360-3807 | 2008-07-16 |
| 1093939712 | Frank Gatyas,d.d.s.,s.c. | Clinic/Center | 623 E Mill St, Plymouth, WI 53073-1944 | 2007-04-12 |
| 1528674157 | Beacon Dental Health PC | Clinic/Center | 3 Market Xing, Plymouth, MA 02360-7841 | 2020-09-18 |
| Find all providers in PLYMOUTH | ||||
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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.