JANESVILLE ENDODONTICS


Address: 1616 N Randall Ave Ste 180, Janesville, WI 53545-1155
Phone: 6083149000

JANESVILLE ENDODONTICS (NPI# 1891319273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891319273
Entity Type Organization
Organization Name JANESVILLE ENDODONTICS
Practice Address 1616 N Randall Ave Ste 180
Janesville
WI 53545-1155
Practice Telephone 6083149000
Practice Fax Number 6083143241
Mailing Telephone 6083149000
Mailing Fax Number 6083143241
Enumeration Date 2020-06-02
Last Update Date 2020-06-02
Authorized Official Name MRS. SOFYA SULIM (OFFICE ADMINISTRATOR)
Authorized Official Telephone 4145202228
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223E0200X Dentist
Specialization: Endodontics
Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI STATE LICENSE 1001926 01
WI NPI NUMBER 1316415086 01

Office Location

Street Address 1616 N RANDALL AVE STE 180
City JANESVILLE
State WI
Zip Code 53545-1155

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1730743816 Wisteria Lyn Gunnink Social Worker 3530 N County Highway F, Janesville, WI 53545 2019-04-24
1730601295 Selma Mohammedi Dentist 1260 Milton Ave Ste 140-150, Janesville, WI 53545 2017-07-16
1205357472 Andrea Jayne Thompson Physical Therapist 3418 N Parker Dr., Janesville, WI 53545 2017-06-28
1639549983 Sylvia Andrus Physical Therapy Assistant 3400 N Country Highway F, Janesville, WI 53545 2015-09-30
1518372564 Kimberly Ann Bishop Registered Nurse 32 E. Racine Street, Suite 150, Janesville, WI 53545 2014-06-29
1679998314 Quirt Family Dentistry Dentist 2201 Humes Road Suite 150, Janesville, WI 53545 2014-03-04
1104163740 Sarah J Fredricks Licensed Practical Nurse 1406 Holiday Drive, Janesville, WI 53545 2013-01-15
1659629335 Parvin Mesbah Pharmacist 2017 Old Humes Road, T-0809, Janesville, WI 53545 2012-08-28
1962797118 Tiffany Schmidt Pharmacist 2017 Humes Road, T-0809, Janesv Ille, WI 53545 2011-06-16
1174817795 Megan Steiner Dentist 1504 Creston Park Drive, Janesville, WI 53545 2011-05-31
Find all providers in zip 53545

Taxonomy Information

Taxonomy Code 1223E0200X
Grouping Dental Providers
Classification Dentist
Specialization Endodontics

Taxonomy Definition

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1164031464 Central Wisconsin Endodontic Specialists LLC Dentist 2606 Stewart Avenue, #102, Wausau, WI 54401 2020-07-23
1306480918 Teng Kai Ong Dentist 1801 West Wisconsin Ave., Milwaukee, WI 53233 2019-11-06
1215344478 Helen Tsao Dentist 2606 Stewart Ave, Ste 102, Wausau, WI 54401-5502 2014-07-18
1275973166 Meridian Endodontics and Periodontics Dentist 20350 Water Tower Blvd Ste 203, Brookfield, WI 53045-3558 2013-06-25
1447698451 Eva C Dahl Dentist 2700 National Dr Ste 1, Onalaska, WI 54650-6708 2013-06-12
1275873374 F Kris Olsen Dentist 1320 S Green Bay Road, Racine Dental Group, Racine, WI 53406 2013-02-26
1063710655 Erik Daniel Deyoung Dentist 6100 W State St, Apt. 636, Wauwatosa, WI 53213-2983 2011-03-05
1376786285 Ronald David Meyers Dentist 2600 N Mayfair Rd Ste 240, Wauwatosa, WI 53226-1309 2009-04-08
1942450457 Wisconsin Endodontic Group, S.c. Dentist 2600 N. Mayfair Rd., Ste 240, Wauwatosa, WI 53226 2008-09-22
1558519058 Kendra Kay Boda Dentist 3004 Golf Rd Ste 102, Eau Claire, WI 54701-8794 2008-09-09
Find all providers with the same taxonomy

Competitor

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City JANESVILLE
Zip Code 53545

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Dataset Information

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.

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