EASTPARK DENTAL LLC NPI 1679809974

NPI Information

  • NPI: 1679809974
  • Provider Name: EASTPARK DENTAL LLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • CLIA Number: 52D2311297
  • Address: 5100 EASTPARK BLVD
    SUITE 110
    MADISON, WI
    ZIP 53718
  • Phone: (608) 222-8232

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NPI Details

EASTPARK DENTAL LLC is a general practice dentist in Madison, 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. EASTPARK DENTAL LLC NPI is 1679809974. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5100 EASTPARK BLVD
SUITE 110
MADISON, WI
ZIP 53718-149
Phone: (608) 222-8232
Fax: (608) 222-8340

The provider's authorized official is Karl Weaver .
The authorized official title is Dentist and has the following contact phone number (608) 222-8232.

The CLIA number assigned to this NPI record is 52D2311297 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/22/2009 and was last updated on 10/22/2009.

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 Practice4943WISCONSINYes

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: 3/30/2025

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