WISCONSIN DENTAL GROUP, S.C. (NPI# 1417087479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417087479 |
| Entity Type | Organization |
| Organization Name | WISCONSIN DENTAL GROUP, S.C. |
| Other Organization Name | FORWARD DENTAL |
| Practice Address |
705 S 24th Ave The Galleria, Suite 430 Wausau WI 54401-5242 |
| Practice Telephone | 7158423933 |
| Practice Fax Number | 7158483483 |
| Mailing Telephone | 7158423933 |
| Mailing Fax Number | 7158483483 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PETER YOUNG (VP) |
| Authorized Official Telephone | 4143572040 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Forward Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881726412 | Wisconsin Dental Group, S.c. | Dentist | 5100 W Forest Home Ave, Milwaukee, WI 53219-4527 | 2007-03-09 |
| 1952431090 | Wisconsin Dental Group, S.c. | Dentist | 15100 W. Library Lane, New Berlin, WI 53151 | 2007-03-07 |
| 1366572927 | Wisconsin Dental Group, S.c. | Dentist | 6218 Washington Ave Ste C, Racine, WI 53406-3916 | 2007-03-06 |
| 1194855742 | Wisconsin Dental Group, S.c. | Dentist | 1025 S Moorland Rd Ste 201, Brookfield, WI 53005-6945 | 2007-03-06 |
| 1548390404 | Wisconsin Dental Group, S.c. | Dentist | 10058 W Loomis Rd, Franklin, WI 53132-8109 | 2007-03-07 |
| 1023148681 | Wisconsin Dental Group, S.c. | Dentist | 1407 N Wright Rd, Janesville, WI 53546-1314 | 2007-03-06 |
| 1144350703 | Wisconsin Dental Group, S.c. | Dentist | 3410 80th St, Kenosha, WI 53142-4975 | 2007-03-06 |
| 1437289006 | Wisconsin Dental Group, S.c. | Dentist | 3715 Washington Rd, Kenosha, WI 53144-1629 | 2007-03-06 |
| 1578693149 | Wisconsin Dental Group, S.c. | Dentist | N80w17707 Custer Ln, Menomonee Falls, WI 53051-3630 | 2007-03-06 |
| 1467582916 | Wisconsin Dental Group, S.c. | Dentist | 9134 W Silver Spring Dr, Milwaukee, WI 53225-3414 | 2007-03-06 |
| Street Address |
705 S 24TH AVE THE GALLERIA, SUITE 430 |
| City | WAUSAU |
| State | WI |
| Zip Code | 54401-5242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861407660 | Gabriella Ann Hangiandreou | Psychiatry & Neurology | 705 S 24th Ave, Chw Community Services Child and Family Counseling, Wausau, WI 54401-5242 | 2006-07-30 |
| 1245646082 | Wausau Smiles, LLC | Dentist | 705 S 24th Ave, Wausau, WI 54401-5242 | 2014-07-01 |
| 1760894034 | Esther Witter | Counselor | 705 S 24th Ave, Wausau, WI 54401-5242 | 2014-05-21 |
| 1508150327 | Lisa J Harrenstein | Counselor | 705 S 24th Ave, Suite 400, Wausau, WI 54401-5242 | 2011-06-09 |
| 1881924181 | Susan Kay O'day | Counselor | 705 S 24th Ave, Galleria Iv, Suite 402, Wausau, WI 54401-5242 | 2010-01-08 |
| 1083941629 | Stacey E Saunders | Social Worker | 705 S 24th Ave, Wausau, WI 54401-5242 | 2009-11-03 |
| 1881860559 | Susan A. Weimerskirch | Social Worker | 705 S 24th Ave, Suite 402, Wausau, WI 54401-5242 | 2008-05-02 |
| 1497884597 | Children's Service Society | Counselor | 705 S 24th Ave, Ste 400, Wausau, WI 54401-5242 | 2007-03-05 |
| 1467519918 | Jack Stacker | Dentist | 705 S 24th Ave, Suite 430, Wausau, WI 54401-5242 | 2007-01-03 |
| 1134286297 | Thomas Krembs | Dentist | 705 S 24th Ave, Suite 430, Wausau, WI 54401-5242 | 2007-01-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1336701895 | Amy Kluetz | Counselor | 3000 Westhill Drive, Suite 100, Wausau, WI 54401 | 2019-07-05 |
| 1437640877 | Joseph T Fitz | Student in an Organized Health Care Education/Training Program | Aspirus Wausau Family Medicine, 425 Wind Ridge Drive, Wausau, WI 54401 | 2018-05-22 |
| 1699293241 | Amanda Nedd | Dietitian, Registered | 425 Pine Ridge Boulevard Suite 220 C, Wausau, WI 54401 | 2017-09-05 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1013389618 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 2727 Plaza Dr., Wausau, WI 54401 | 2015-10-22 |
| 1881091163 | Judy Lao | Dental Hygienist | 413 North 17th Avenue, Wausau, WI 54401 | 2014-12-02 |
| 1295012011 | Allison Waraksa | Pharmacist | 504 S. 17th Ave, Wausau, WI 54401 | 2011-11-08 |
| 1881974053 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 504 S 17th Ave, Wausau, WI 54401 | 2011-08-19 |
| Find all providers in zip 54401 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558837658 | Peerenboom Dental LLC | Dentist | 1 Corporate Dr Ste 100, Wausau, WI 54401-1724 | 2018-10-17 |
| 1437641214 | Kohl Dental LLC | Dentist | 1 Corporate Dr Ste 104, Wausau, WI 54401-1725 | 2018-06-06 |
| 1750836623 | Joshua Flavin | Dentist | 200 E Bridge St Ste 100, Wausau, WI 54403-3574 | 2016-08-22 |
| 1114342847 | Sleep Apnea Care and Wellness LLC | Dentist | 413 N 17th Ave Ste 100, Wausau, WI 54401-4287 | 2014-03-05 |
| 1841594603 | Daniel L. Schaut | Dentist | 1723 Mulligan Dr., Wausau, WI 54403 | 2011-01-07 |
| 1700085933 | Ronald Scott Prehn | Dentist | 6 North Hill Road, Wausau, WI 54403 | 2007-07-17 |
| 1265652226 | Patrick Robert Morath Sr. | Dentist | 210 Mcclellan St, Suite 310, Wausau, WI 54403 | 2007-05-01 |
| 1043341993 | Craig B Thiessen | Dentist | 311 Financial Way, Suite 240, Wausau, WI 54401-4288 | 2007-03-09 |
| 1225106958 | Kevin Lee Lovell | Dentist | 3319 Terrace Ct, Wausau, WI 54401 | 2006-12-01 |
| 1649377862 | John Adam Krasowski | Dentist | 550 N 17th Ave, Suite 2, Wausau, WI 54401 | 2006-09-20 |
| Find all providers in WAUSAU | ||||
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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.