RIVERSIDE DENTAL CARE LLC NPI 1104603513

NPI Information

  • NPI: 1104603513
  • Provider Name: RIVERSIDE DENTAL CARE LLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 1805 E MAIN ST
    LITTLE CHUTE, WI
    ZIP 54140
  • Phone: (303) 994-1456

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NPI Details

RIVERSIDE DENTAL CARE LLC is a general practice dentist in Little Chute, 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. RIVERSIDE DENTAL CARE LLC NPI is 1104603513. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1805 E MAIN ST
LITTLE CHUTE, WI
ZIP 54140-455
Phone: (303) 994-1456

The provider's authorized official is Elese Mcclarie .
The authorized official title is Dentist and has the following contact phone number (303) 994-1456.

The enumeration date for this NPI number is 9/11/2023 and was last updated on 2/11/2025.

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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