CHIPPEWA VALLEY TECHNICAL COLLEGE NPI 1093868358

NPI Information

NPI: 1093868358
Provider Name: CHIPPEWA VALLEY TECHNICAL COLLEGE
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Organization
CLIA Number: 52D0950836
Address: 620 W CLAIREMONT AVE
HEC 120
EAU CLAIRE, WI
ZIP 54701
Phone: (715) 833-6271

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NPI Details

CHIPPEWA VALLEY TECHNICAL COLLEGE is a general practice dentist in Eau Claire, 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. CHIPPEWA VALLEY TECHNICAL COLLEGE NPI is 1093868358. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

620 W CLAIREMONT AVE
HEC 120
EAU CLAIRE, WI
ZIP 54701-120
Phone: (715) 833-6271
Fax: (715) 833-6447

The provider's authorized official is Shelly Olson .
The authorized official title is Campus Administrator and has the following contact phone number (715) 833-6675.

The CLIA number assigned to this NPI record is 52D0950836 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/19/2007 and was last updated on 4/19/2013.

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	Primary
1	1223S0112X	Dentist	Oral and Maxillofacial Surgery	No
2	1223P0221X	Dentist	Pediatric Dentistry	No
3	1223D0001X	Dentist	Dental Public Health	No
4	1223G0001X	Dentist	General Practice	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	38394300	OTHER	WISCONSIN	BADGER CARE

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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