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UPPER LAKES DENTAL, LLC
NPI 1124580352
Clinic/Center - Dental in Winneconne, WI

Active since April 05, 2019
908 E MAIN ST STE C, WINNECONNE, WI 54986(920) 582-0688 Get Directions Write a Review

NPPES record last updated: April 5, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Upper Lakes Dental, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UPPER LAKES DENTAL, LLC (NPI 1124580352) is a healthcare organization registered as a dental in Winneconne, Wisconsin and active in the NPI registry since April 2019. The organization lists Ryan Gonzalez, Owner, as its authorized official.

NPPES Registry Identity

NPI1124580352
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameUPPER LAKES DENTAL, LLC
Location Address908 E MAIN ST STE CWinneconne, WI 54986-9672
Mailing AddressPo Box 369Winneconne, WI 54986-0369 · (920) 582-0688
Phone(920) 582-0688
Organization SubpartNo
Authorized OfficialRyan GonzalezOwner · (920) 582-0688
Enumeration DateApril 5, 2019
✔ NPI 1124580352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
908 E MAIN ST STE C, Winneconne, WI 54986
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Upper Lakes Dental, LLC's NPI number?

The NPI number for Upper Lakes Dental, LLC is 1124580352. It was assigned to this organization in the NPPES registry on April 5, 2019.

Where is Upper Lakes Dental, LLC located?

Upper Lakes Dental, LLC is located at 908 E Main St Ste C, Winneconne, WI 54986. The listed phone number is (920) 582-0688.

What is Upper Lakes Dental, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Upper Lakes Dental, LLC was last updated on April 5, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.