LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS (NPI# 1427347426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427347426 |
| Entity Type | Organization |
| Organization Name | LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS |
| Other Organization Name | PETER CHRISTENSEN DENTAL CLINIC |
| Practice Address |
128 Old Abe Rd Lac Du Flambeau WI 54538-9682 |
| Mailing Address |
128 Old Abe Road Lac Du Flambeau WI 54538-9682 |
| Practice Telephone | 7155884466 |
| Practice Fax Number | 7155882269 |
| Mailing Telephone | 7155884466 |
| Mailing Fax Number | 7155882269 |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2014-01-28 |
| Authorized Official Name | JEANNE M WOLFE (COMPLIANCE OFFICER) |
| Authorized Official Telephone | 7155884466 |
| Authorized Official Credential | BACHELORS DEGREE |
| Is Organization Subpart | Y |
| Parent Organization Name | LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Peter Christensen Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669970729 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Clinic/Center | 3378 N. Schilleman Rd, Lac Du Flambeau, WI 54538-0815 | 2018-01-24 |
| 1861885014 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Community/Behavioral Health | 533 Peace Pipe Rd, Lac Du Flambeau, WI 54538-9123 | 2015-03-12 |
| 1306016563 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Case Management | 533 Peace Pipe Road, Lac Du Flambeau, WI 54538-0189 | 2008-03-04 |
| 1134235047 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Clinic/Center | 129 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2006-08-22 |
| 1447271408 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 129 Old Abe Rd, Lac Du Flambeau, WI 54538 | 2006-07-22 |
| Street Address |
128 OLD ABE RD |
| City | LAC DU FLAMBEAU |
| State | WI |
| Zip Code | 54538-9682 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477611432 | Gary Louis Gusmerotti | Dentist | 128 Old Abe Rd, Lac Du Flambeau, WI 54538-0128 | 2006-12-04 |
| 1003421272 | Peter James Nebel | Dentist | 128 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2020-09-14 |
| 1023677879 | Nicole Maletzke | Dentist | 128 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2019-06-06 |
| 1245788330 | Dj Foster | Dentist | 128 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2016-09-17 |
| 1649675745 | Linda Smith | Dental Hygienist | 128 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2014-10-31 |
| 1992106033 | Erin Wozniak | Dental Hygienist | 128 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2014-09-09 |
| 1275948416 | Chrystal Sacheen Wedde | Dental Hygienist | 128 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2014-06-26 |
| 1346660297 | Michelle Rollman | Dental Hygienist | 128 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2014-04-18 |
| 1265869325 | Alyse Kate Nitke | Dental Hygienist | 128 Old Abe Rd, Lac Du Flambeau, WI 54538-0128 | 2013-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265757256 | Stacey Dean | Registered Nurse | 8727 West Squaw Lake Road, Lac Du Flambeau, WI 54538 | 2010-04-01 |
| 1447398532 | Wendy Lindstrom | Counselor | 533 Peace Pipe Rd, Lac Du Flambeau, WI 54538 | 2007-02-02 |
| 1932295581 | Rick Lee Howe | Pharmacist | 450 Ols Abe Road, Lac Du Flambeau, WI 54538 | 2006-10-04 |
| 1902990534 | Timothy P. Obukowicz | Pharmacist | 450 Old Abe Road, Lac Du Flambeau, WI 54538 | 2006-10-03 |
| 1295849420 | Brian D Schafer | Pharmacist | 129 Old Abe Road, Lac Du Flambeau, WI 54538 | 2006-08-17 |
| 1720071723 | Town of Lac Du Flambeau | Ambulance | 614 Wild Rice Avenue, Lac Du Flambeau, WI 54538 | 2005-08-24 |
| 1508223066 | Amber Bickler | Dental Hygienist | 128 Old Abe Road, Lac Du Flambeau, WI 54538 | 2016-01-28 |
| 1689712770 | Linda M Daniels | Counselor | 533 Peace Pipe Rd, Lac Du Flambeau, WI 54538 | 2007-02-02 |
| 1447271408 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 129 Old Abe Rd, Lac Du Flambeau, WI 54538 | 2006-07-22 |
| 1073940136 | Sarah Jean Galloy | Dental Hygienist | 128 Old Abe Road, Lac Du Flambeau, WI 54538-0128 | 2013-10-03 |
| Find all providers in zip 54538 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| 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 |
| 1124580352 | Upper Lakes Dental, LLC | Clinic/Center | 908 E Main St Ste C, Winneconne, WI 54986-9672 | 2019-04-05 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | LAC DU FLAMBEAU |
| Zip Code | 54538 |
Please comment or provide details below to improve the information on LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS.
| 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.