BLACK BEAR DENTAL LLC NPI 1083575492

NPI Information

  • NPI: 1083575492
  • Provider Name: BLACK BEAR DENTAL LLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 2901 PIONEER AVE
    RICE LAKE, WI
    ZIP 54868
  • Phone: (715) 609-2461

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NPI Details

BLACK BEAR DENTAL LLC is a general practice dentist in Rice Lake, 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. BLACK BEAR DENTAL LLC NPI is 1083575492. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2901 PIONEER AVE
RICE LAKE, WI
ZIP 54868-434
Phone: (715) 609-2461
Fax: (920) 626-6377

The provider's authorized official is Jason William Isaacson .
The authorized official title is Owner/dentist and has the following contact phone number (715) 609-2461.

The enumeration date for this NPI number is 11/24/2025 and was last updated on 11/24/2025.

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 PracticeYes

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: 11/21/2025

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