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WHITEHALL DENTAL CENTER LLC NPI 1578215174


NPI Information

NPI: 1578215174
Provider Name: WHITEHALL DENTAL CENTER LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 52D2222289

Address:
36220 TOWER DR
WHITEHALL, WI
ZIP 54773
Phone: (715) 538-1800
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WHITEHALL DENTAL CENTER LLC is a general practice dentist in Whitehall, 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. WHITEHALL DENTAL CENTER LLC NPI is 1578215174. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

36220 TOWER DR
WHITEHALL, WI
ZIP 54773-524
Phone: (715) 538-1800

The provider's authorized official is Aaron Bushong .
The authorized official title is Owner and has the following contact phone number (715) 573-3546.

The CLIA number assigned to this NPI record is 52D2222289 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/25/2022 and was last updated on 1/25/2022.


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: 5/5/2024

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