KIDS DENTAL EXPERTS LLC NPI 1730397233

NPI Information

NPI: 1730397233
Provider Name: KIDS DENTAL EXPERTS LLC

Former Legal Business Name: PARK-WEST PEDIATRIC DENTAL ASSOCIATES

Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
125 SIEGLER ST
GREEN BAY, WI
ZIP 54303
Phone: (920) 592-8940
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KIDS DENTAL EXPERTS LLC is a pediatric dentistry dentist in Green Bay, WI. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. KIDS DENTAL EXPERTS LLC NPI is 1730397233. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Park-west Pediatric Dental Associates.

The provider's business location address is:

125 SIEGLER ST
GREEN BAY, WI
ZIP 54303-635
Phone: (920) 592-8940

The provider's authorized official is Eric James Van Miller .
The authorized official title is Owner Dentist and has the following contact phone number (920) 592-8940.

The enumeration date for this NPI number is 5/18/2007 and was last updated on 2/22/2024.

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
1	1223P0221X	Dentist	Pediatric Dentistry	5182-015	WISCONSIN	Yes

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: 4/28/2024

NPI Synchronization or Removal

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