NORTHEAST ORTHODONTIC ASSOCIATES. L.L.C. (NPI# 1831382134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831382134 |
| Entity Type | Organization |
| Organization Name | NORTHEAST ORTHODONTIC ASSOCIATES. L.L.C. |
| Practice Address |
25 5th St Ne Watertown SD 57201-3712 |
| Mailing Address |
25 5th St Ne P O Box 1450 Watertown SD 57201-3712 |
| Practice Telephone | 6058821500 |
| Practice Fax Number | 6058827090 |
| Mailing Telephone | 6058821500 |
| Mailing Fax Number | 6058827090 |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-08-21 |
| Authorized Official Name | DR. RYAN K VAN LAECKEN (OWNER) |
| Authorized Official Telephone | 6058822772 |
| Authorized Official Credential | D.D.S., M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
M817 | SD | Dental Providers |
| Street Address |
25 5TH ST NE |
| City | WATERTOWN |
| State | SD |
| Zip Code | 57201-3712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245878032 | Samantha Kay Kratovil | Dietitian, Registered | 4 19th St Ne, Watertown, SD 57201 | 2019-12-12 |
| 1326516501 | Edgewood Watertown Mc 2 LLC | Assisted Living Facility | 225 14 Ave Ne, Watertown, SD 57201 | 2018-11-06 |
| 1023503406 | Rhonda Jean Cyre | Occupational Therapy Assistant | 613 B 1st Ave Se, Watertown, SD 57201 | 2018-06-27 |
| 1083160717 | Joyce Anderson | Psychologist | 1124 Konrady Dr. Ne, Watertown, SD 57201 | 2016-09-01 |
| 1336584630 | Jeffrey Alan Dorrity | Otolaryngology | 1201 Mickelson Dr, Watertown, SD 57201 | 2013-05-01 |
| 1427397389 | Vickie Lynn Burchatz | Occupational Therapy Assistant | 415 Fourth Avenue Ne, Golden Living Center, Watertown, SD 57201 | 2013-02-12 |
| 1215292560 | Eagle Vision | Eyewear Supplier (Equipment, not the service) | 906 1/2 9th Ave Se, Watertown, SD 57201 | 2012-07-11 |
| 1669777462 | Eve Lynn Hensler | Audiologist | 405 18th Ave. Ne, Professional Hearing Services, Inc., Watertown, SD 57201 | 2011-01-26 |
| 1760792261 | Maria Redmond | Physical Therapist | 810 South Maple, Watertown, SD 57201 | 2010-10-18 |
| 1194918995 | Colette Wheeler | Occupational Therapist | 17330, 458th Ave, Watertown, SD 57201 | 2007-08-24 |
| Find all providers in zip 57201 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538604178 | Donald C Demas, Dds, Ms, PC | Dentist | 51 Depot St Ste 505, Watertown, CT 06795-2685 | 2017-01-05 |
| 1659556660 | Kellie A. Sanzone | Dentist | 1114 Washington St, Watertown, NY 13601-4353 | 2008-01-09 |
| 1003009903 | Ryan K Vanlaecken | Dentist | 600 4th St Ne Ste 103, Watertown, SD 57201-1898 | 2007-08-23 |
| 1023237559 | Orthodontic Associates, S.c. | Dentist | 1510 Doctors Ct, Watertown, WI 53094-4102 | 2007-04-24 |
| 1275683021 | Anna Karina Simon-villalba | Dentist | 51 Galen St Ste 2, Watertown, MA 02472-4503 | 2007-01-12 |
| 1578643854 | David W Longworth | Dentist | 6 S Broadway, Watertown, SD 57201-3604 | 2006-10-17 |
| 1548797590 | Sean O'dell Dds Pllc | Dentist | 6 S Broadway, Watertown, SD 57201-3604 | 2017-05-20 |
| 1922475458 | Audra Long | Dentist | 1510 Doctors Ct, Watertown, WI 53094-4102 | 2015-09-01 |
| 1063711109 | Robert Stephen Vanlaecken | Dentist | 600 4th St Ne Ste 103, Watertown, SD 57201-1898 | 2011-03-15 |
| 1346410024 | Ms Orthodontics Associates LLC | Dentist | 106 Mount Auburn St, Suite 1a, Watertown, MA 02472-3968 | 2008-03-10 |
| Find all providers in WATERTOWN | ||||
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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.