MISHICOT DENTAL NPI 1407006869

NPI Information

  • NPI: 1407006869
  • Provider Name: MISHICOT DENTAL
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 105 N PARK LN
    MISHICOT, WI
    ZIP 54228
  • Phone: (920) 755-2336

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NPI Details

MISHICOT DENTAL is a general practice dentist in Mishicot, WI. The provider is 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. MISHICOT DENTAL NPI is 1407006869. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

105 N PARK LN
MISHICOT, WI
ZIP 54228-537
Phone: (920) 755-2336

The provider's authorized official is Jason Allen Thiel .
The authorized official title is President / Dentist and has the following contact phone number (920) 755-2336.

The enumeration date for this NPI number is 9/23/2008 and was last updated on 9/23/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice5096-015WISCONSINYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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