FENNIMORE DENTAL LLC NPI 1801367545

NPI Information

  • NPI: 1801367545
  • Provider Name: FENNIMORE DENTAL, LLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 220 LINCOLN AVENUE
    FENNIMORE, WI
    ZIP 53809
  • Phone: (608) 822-3770

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NPI Details

FENNIMORE DENTAL, LLC is a general practice dentist in Fennimore, 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. FENNIMORE DENTAL, LLC NPI is 1801367545. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

220 LINCOLN AVENUE
FENNIMORE, WI
ZIP 53809
Phone: (608) 822-3770
Fax: (608) 822-7680

The provider's authorized official is Zhenyu Liang .
The authorized official title is General Dentist and has the following contact phone number (608) 822-3770.

The enumeration date for this NPI number is 12/6/2018 and was last updated on 12/6/2018.

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

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
103359042MEDICAIDNEW YORK

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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