PERIODONTICS AND IMPLANT DENTISTRY, LLC (NPI# 1710431788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710431788 |
| Entity Type | Organization |
| Organization Name | PERIODONTICS AND IMPLANT DENTISTRY, LLC |
| Practice Address |
6754 Lindermann Ave Mount Pleasant WI 53406-5603 |
| Practice Telephone | 2626325455 |
| Practice Fax Number | 2626322858 |
| Mailing Telephone | 2626325455 |
| Mailing Fax Number | 2626322858 |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2016-08-08 |
| Authorized Official Name | DR. CHRISTOPHER G HUTTON (SOLE MEMBER) |
| Authorized Official Telephone | 4143692091 |
| 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 |
6754 LINDERMANN AVE |
| City | MOUNT PLEASANT |
| State | WI |
| Zip Code | 53406-5603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306345814 | J P Irelan Endodontics LLC | Dentist | 6754 Lindermann Ave, Mount Pleasant, WI 53406-5603 | 2018-02-09 |
| 1184069379 | Christopher G Hutton | Dentist | 6754 Lindermann Ave, Mount Pleasant, WI 53406 | 2013-05-01 |
| 1568728046 | G.s. Miceli, Dpm, S.c. | Podiatrist | 6754 Lindermann Ave, Mount Pleasant, WI 53406-5603 | 2012-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
| 1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
| 1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
| 1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| Find all providers in zip 53406 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912463795 | Hush Dsm LLC | Clinic/Center | 3324 Olympic Ln, Mount Pleasant, SC 29466-8998 | 2019-02-16 |
| 1518568005 | Oasis Family Dentistry LLC | Clinic/Center | 1127 Queensborough Blvd Ste 107, Mount Pleasant, SC 29464-5432 | 2020-11-03 |
| 1013524602 | Merritt Family Dentistry, LLC | Clinic/Center | 1441 N Point Ln, Mount Pleasant, SC 29464-4624 | 2020-09-28 |
| 1467976878 | Dr. Tatiana Lucas, Dds Family Dentistry, Pllc | Clinic/Center | 272 Cross Roads Plz, Mount Pleasant, PA 15666-2288 | 2017-07-27 |
| 1215227020 | Rivertowne Family Dentistry | Clinic/Center | 2023 Highway 41, Mount Pleasant, SC 29466-6200 | 2011-04-13 |
| 1326206129 | Nash Orthodontics Practice LLC | Clinic/Center | 1127 Queensborough Blvd, Suite 107, Mount Pleasant, SC 29464-5431 | 2008-05-28 |
| 1790955359 | Nathan S. Huntington, Dds, PC | Clinic/Center | 1055 S Medical Dr, Mount Pleasant, UT 84647-2261 | 2008-03-10 |
| 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 | MOUNT PLEASANT |
| Zip Code | 53406 |
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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.