BEAVER DAM DENTAL LLC NPI 1699985051

NPI Information

  • NPI: 1699985051
  • Provider Name: BEAVER DAM DENTAL LLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 302 N SPRING ST
    BEAVER DAM, WI
    ZIP 53916
  • Phone: (920) 887-8421

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NPI Details

BEAVER DAM DENTAL LLC is a general practice dentist in Beaver Dam, 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. BEAVER DAM DENTAL LLC NPI is 1699985051. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

302 N SPRING ST
BEAVER DAM, WI
ZIP 53916-044
Phone: (920) 887-8421
Fax: (920) 887-8431

The provider's authorized official is Genevieve E Poppe .
The authorized official title is Partner and has the following contact phone number (608) 358-3370.

The enumeration date for this NPI number is 5/23/2007 and was last updated on 1/31/2013.

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 License Number License State Primary
11223G0001XDentistGeneral Practice1384GWISCONSINNo
21223G0001XDentistGeneral Practice6749-015WISCONSINNo
31223G0001XDentistGeneral Practice3480WISCONSINYes

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
133555900MEDICAIDWISCONSIN
21871881169MEDICAIDWISCONSIN
333477900MEDICAIDWISCONSIN

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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