COMMUNITY DENTAL CLINIC (NPI# 1528244613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528244613 |
| Entity Type | Organization |
| Organization Name | COMMUNITY DENTAL CLINIC |
| Practice Address |
520 Handeyside Suite 4 Fort Atkinson WI 53538 |
| Practice Telephone | 9205634372 |
| Practice Fax Number | 9204634374 |
| Mailing Telephone | 9205634372 |
| Mailing Fax Number | 9204634374 |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2012-02-27 |
| Authorized Official Name | MRS. BARB MORRISON GUDGEON (COORDINATOR) |
| Authorized Official Telephone | 9205634372 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 38397100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114241494 | Community Dental Clinic | Dentist | 7750 W 200 S, Topeka, IN 46571-9436 | 2010-03-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | COMMUNITY DENTAL CLINIC | 66 Morrisville Plaza, Morrisville, VT 05661 |
| Colorado Business Entities | COMMUNITY DENTAL CLINIC, INC. | 87 Merchant Drive, Montrose, CO 81401 |
| Street Address |
520 HANDEYSIDE SUITE 4 |
| City | FORT ATKINSON |
| State | WI |
| Zip Code | 53538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902370695 | Home Care Assistance Services, LLC | In Home Supportive Care | 1001 Madison Avenue, Suite C, Fort Atkinson, WI 53538 | 2019-01-15 |
| 1609367291 | David Lewis | Physical Therapy Assistant | 431 Raintree Dr, Fort Atkinson, WI 53538 | 2018-05-20 |
| 1972093706 | City of Fort Atkinson | Ambulance | 124 Milwaukee Ave W, Fort Atkinson, WI 53538 | 2018-05-17 |
| 1306383468 | Chelsey Turk | Specialist/Technologist | 1231 Orchard Lane, Fort Atkinson, WI 53538 | 2017-01-27 |
| 1639625452 | Insight Counseling Services | Community/Behavioral Health | 615 Frederick Ave., Fort Atkinson, WI 53538 | 2016-08-31 |
| 1912355314 | Melissa Anne Gleason Trimbell | Dentist | 520 Handeyside Ln Ste 4, Fort Atkinson, WI 53538 | 2016-05-26 |
| 1295141943 | Brittany K Romans | Registered Nurse | 1230 Commonwealth Dr, 1, Fort Atkinson, WI 53538 | 2014-07-02 |
| 1023367117 | June Ann Sullivan | Occupational Therapy Assistant | 815 West Cramer Street, Fort Atkinson, WI 53538 | 2012-09-05 |
| 1306080551 | Mary Kathleen Bornick | Licensed Practical Nurse | W. 6143 N. Thornapple Court, Fort Atkinson, WI 53538 | 2009-04-30 |
| 1710169214 | Joan Elizabeth Dams | Registered Nurse | W8339 Perry Rd, Apt 2, Ft Atkinson, WI 53538 | 2007-11-27 |
| Find all providers in zip 53538 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386161420 | Podoll Dental, LLC | Clinic/Center | 715 Sherman Ave E, Fort Atkinson, WI 53538-1992 | 2017-08-29 |
| 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 | FORT ATKINSON |
| Zip Code | 53538 |
Please comment or provide details below to improve the information on COMMUNITY DENTAL CLINIC.
| 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.