BAY ORAL SURGERY & IMPLANT CENTER, LTD (NPI# 1427270776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427270776 |
| Entity Type | Organization |
| Organization Name | BAY ORAL SURGERY & IMPLANT CENTER, LTD |
| Other Organization Name | BAY ORAL & MAXILLOFACIAL SURGERY, LTD |
| Practice Address |
2353 S Ridge Road Green Bay WI 54304 |
| Practice Telephone | 9204990471 |
| Practice Fax Number | 9204998312 |
| Mailing Telephone | 9204990471 |
| Mailing Fax Number | 9204998312 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2014-12-16 |
| Authorized Official Name | ELLEN M GREENE (PRACTICE ADMINSTRAT) |
| Authorized Official Telephone | 9204990471 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Bay Oral & Maxillofacial Surgery, LTD | Former Legal Business Name - Organization |
| Street Address |
2353 S RIDGE ROAD |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689196255 | Kristen Ashley Haltom | Registered Nurse | 2979 Allied St Suite C, Green Bay, WI 54304 | 2017-07-14 |
| 1649671421 | Heather Marie Novak | Counselor | 2979 Allied St Unit C, Green Bay, WI 54304 | 2014-09-11 |
| 1356777684 | Nathan Weir | Specialist/Technologist | 1265 Lombardi Avenue, Green Bay, WI 54304 | 2013-09-18 |
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1447551379 | Citralina M Haruo | Community Health Worker | 1110 11th Avenue, Green Bay, WI 54304 | 2010-11-09 |
| 1497061352 | Daniel James Gustin | Pharmacist | 1109 Lombardi Ave, Green Bay, WI 54304 | 2010-08-28 |
| 1316259898 | Karen A Detrick | Occupational Therapy Assistant | 1040 Pilgram Way, Woodside Senior Communities, Green Bay, WI 54304 | 2010-07-13 |
| 1861667362 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 2605 S. Oneida St. Suite 107, Green Bay, WI 54304 | 2008-04-25 |
| 1891967303 | Kimberley M Welk | Marriage & Family Therapist | 926 Willard Dr Ste 136, Green Bay, WI 54304 | 2008-03-25 |
| 1750563698 | Richard Lawrence Beyer | Hearing Instrument Specialist | 2154 S Ridge Rd, Green Bay, WI 54304 | 2007-12-03 |
| Find all providers in zip 54304 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588688105 | Michael M Miskella | Dentist | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2006-07-27 |
| 1578583654 | William J Nelson | Dentist | 2581 Development Dr, Green Bay, WI 54311-4247 | 2006-07-20 |
| 1396001483 | Chad Randall Seubert | Dentist | 2581 Development Dr, Green Bay, WI 54311-4247 | 2012-04-03 |
| 1861592529 | Bernadette L Wilson | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2006-09-23 |
| 1922019405 | Timothy J Flanigan | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2006-08-10 |
| 1447264502 | David L Lemoine | Dentist | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2006-07-27 |
| 1447274071 | Vijay S Parmar | Dentist | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2006-07-27 |
| 1013921196 | Bradley S Koch | Dentist | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2006-07-27 |
| 1356355424 | Jason L Lemoine | Dentist | 2353 S Ridge Rd, Green Bay, WI 54304-5069 | 2006-07-27 |
| 1174545982 | Steve A Zent | Dentist | 2581 Development Dr, Green Bay, WI 54311-4247 | 2006-07-24 |
| 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.