DEFOREST DENTAL SERVICES (NPI# 1730282344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730282344 |
| Entity Type | Organization |
| Organization Name | DEFOREST DENTAL SERVICES |
| Practice Address |
210 N. Main St. Ste 103 Deforest WI 53532 |
| Practice Telephone | 6088463948 |
| Practice Fax Number | 6088467526 |
| Mailing Telephone | 6088463948 |
| Mailing Fax Number | 6088467526 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. GERALD ROGER CORCORAN (PRESIDENT) |
| Authorized Official Telephone | 6088463948 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2412WI | WI | Dental Providers |
| Street Address |
210 N. MAIN ST. STE 103 |
| City | DEFOREST |
| State | WI |
| Zip Code | 53532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952650541 | Laura B Cole | Licensed Practical Nurse | 405 Anderson St., Deforest, WI 53532 | 2012-08-29 |
| 1043429707 | Tracy Beth Head | Pharmacist | 643 S. Main Street, Deforest, WI 53532 | 2007-05-21 |
| 1588702237 | Patricia Herschleb | Pharmacist | W6850 County Road Dm, De Forest, WI 53532 | 2007-02-02 |
| 1821147661 | Kathryn Marie Cacic | Nurse Practitioner | 7752 Clinton Road, Deforest, WI 53532 | 2007-01-10 |
| 1306915079 | Bakke Chiropractic Clinic Sc | Chiropractor | Bakke Chiropractic Clinic Sc, 312 East North Street, Deforest, WI 53532 | 2006-11-07 |
| 1689772485 | Gregg Nelson Bakke | Chiropractor | 312 East North Street, Bakke Chiropractic Clinic Sc, Deforest, WI 53532 | 2006-09-20 |
| 1326038670 | Trixie Irene Eakin | Optometrist | 101 S. Main St, De Forest, WI 53532 | 2005-10-27 |
| 1245663988 | Group Health Cooperative of South Central Wisconsin Deforest Clinic | Durable Medical Equipment & Medical Supplies | 815 S Main St, Deforest, WI 53532 | 2013-08-16 |
| 1205953866 | Essential Family Vision Care, S.c. | Optometrist | 101 S. Main St, De Forest, WI 53532 | 2007-03-26 |
| 1003914821 | David Bruce Bakke | Chiropractor | 312 East North Street, Bakke Chiropractic Clinic Sc, Deforest, WI 53532 | 2006-09-20 |
| Find all providers in zip 53532 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093076978 | Brittany Dyan Burger | Dentist | 210 N Main St, Suite 103, Deforest, WI 53532-1163 | 2012-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700496007 | Elizabeth R Friend | Dentist | 440 Science Dr Ste 100, Madison, WI 53711-1064 | 2020-08-03 |
| 1205451598 | Tysen Wood | Dentist | 605 S 24th Ave Ste 10, Wausau, WI 54401-1705 | 2020-06-11 |
| 1841814035 | Vicki Shah | Dentist | 220 E Commerce Ct, Elkhorn, WI 53121-4371 | 2020-06-03 |
| 1790308666 | Michelle Zellmer | Dentist | 333 W Brown Deer Rd Ste A, Fox Point, WI 53217-2370 | 2020-05-26 |
| 1568083772 | Kolver Matos | Dentist | N112w16286 Mequon Rd, Germantown, WI 53022-3306 | 2020-04-28 |
| 1205466737 | Leyes Robers Dental LLC | Dentist | 3216 W County Rd Kk, Appleton, WI 54915 | 2020-01-23 |
| 1972133536 | Neha Solanki | Dentist | 1212 Horton St Ste 200, La Crosse, WI 54601-6289 | 2020-01-23 |
| 1023655131 | Pak Dental LLC | Dentist | 8241 S Howell Ave Ste 100, Oak Creek, WI 53154-8346 | 2019-12-09 |
| 1700428216 | Binninger Dentistry, LLC | Dentist | 12720 W North Ave Bldg B, Brookfield, WI 53005-4637 | 2019-10-16 |
| 1720629017 | Quirt Family Dentistry, S.c. | Dentist | W178n9379 Water Tower Pl, Menomonee Falls, WI 53051-8034 | 2019-10-08 |
| Find all providers with the same taxonomy | ||||
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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.