KEITH DAVIS (NPI# 1861025090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861025090 |
| Entity Type | Individual |
| Full Name | KEITH DAVIS |
| Credential | DDS |
| Practice Address |
430 Main St Green Bay WI 54301-5115 |
| Mailing Address |
3333 N Mayfair Rd Ste 311 Wauwatosa WI 53222-3219 |
| Practice Telephone | 9204310345 |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
5000617 | WI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225668213 | Keith Davis | Registered Nurse | 10 Elpaso Ct, East Northport, NY 11731-5628 | 2020-01-19 |
| 1184183758 | Keith J Davis | Psychologist | 8113 Crimson Creek Ct, Las Vegas, NV 89139-6909 | 2019-03-13 |
| 1982115036 | Keith W Davis | Chiropractor | 815 E Baseline Rd Ste 106, Tempe, AZ 85283-1572 | 2017-10-17 |
| 1154682573 | Keith Phillip Davis | Pharmacist | 8640 Se Causey Ave Apt S202, Happy Valley, OR 97086-8595 | 2012-06-01 |
| 1528184199 | Keith Alan Davis | Chiropractor | 4640 N Francisco Ave, Chicago, IL 60625-3723 | 2007-03-22 |
| 1346315025 | Keith L Davis | Dentist | 100 Chelsea Corners Way Ste 113, Chelsea, AL 35043-8207 | 2006-11-21 |
| 1952488215 | Keith L Davis | Family Medicine | 741 Scholl Rd, Ste A, Mansfield, OH 44907 | 2006-11-01 |
| 1639268089 | Keith Alan Davis | Ophthalmology | 1011 Sylvan Ave Ste C, Modesto, CA 95350-1693 | 2006-10-12 |
| 1699875419 | Keith G Davis | Chiropractor | 722 Front Street, Casselton, ND 58012-3302 | 2006-09-22 |
| 1104849884 | Keith C. Davis | Dentist | 975 N Church St, Spartanburg, SC 29303-4104 | 2006-07-25 |
| Street Address |
430 MAIN ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-5115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154326924 | John E Zweig | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2005-06-16 |
| 1780232827 | Pranav Bhide | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2019-09-02 |
| 1174180301 | Lalinda Wickramasinghe | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2019-05-23 |
| 1063906188 | Hassan Alshehabi | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2018-06-21 |
| 1235621756 | Jiulin Zhu | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2018-05-31 |
| 1902323298 | Gergana Naskova Nikolova | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2017-08-28 |
| 1922528157 | Pamela Sehra | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2017-06-20 |
| 1982098323 | Jennifer Yessa | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2015-03-24 |
| 1841681525 | Farashta Sediqzad | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2015-02-17 |
| 1235576646 | Amanda Lea Scott | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2013-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| 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 |
|---|---|---|---|---|
| 1508247198 | Lauren Evan Montoure Teske | Dentist | 2000 Shady Ln, Green Bay, WI 54313-9311 | 2015-06-09 |
| 1023410123 | Lee S Bialkowski | Dentist | 2821 S Webster Ave, Green Bay, WI 54301-2878 | 2014-09-19 |
| 1922376706 | Kevin J. Wilke | Dentist | 111 Broadview Dr, Green Bay, WI 54301-2805 | 2011-12-07 |
| 1962737338 | Edward Y Lin | Dentist | 2821 S. Webster Ave., Orthodontic Specialists of Green Bay, Green Bay, WI 54301 | 2009-10-02 |
| 1386850790 | G.d. Pionek,d.d.s.,s.c. | Dentist | 1825 S Webster Ave, Suite 201, Green Bay, WI 54301-2280 | 2007-05-15 |
| 1760551857 | Mark H Hanson | Dentist | 2000 Shady Lane, Green Bay, WI 54313-9311 | 2006-11-06 |
| 1982098323 | Jennifer Yessa | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2015-03-24 |
| 1841681525 | Farashta Sediqzad | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2015-02-17 |
| 1083817845 | Charles E Montoure | Dentist | 2000 Shady Lane, Green Bay, WI 54313-9311 | 2007-06-08 |
| 1194926527 | Charles E. Montoure, Dds, Ms Mark H Hanson, Dds, Ms, Sc | Dentist | 2000 Shady Lane, Green Bay, WI 54313-9311 | 2007-05-31 |
| Find all providers in GREEN BAY | ||||
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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.