GRAND AVENUE DENTAL CARE, LLC
NPI 1255102323
Clinic/Center - Dental in Hartford, WI

NPI Status: Active since January 09, 2024

Contact Information

1163 GRAND AVE
HARTFORD, WI
ZIP 53027
Phone: (262) 673-7826

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Authorized Official
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Clinic/Center
Dental
Accepts Insurance

About GRAND AVENUE DENTAL CARE, LLC

This page provides the complete NPI Profile along with additional information for Grand Avenue Dental Care, Llc, a provider established in Hartford, Wisconsin operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1255102323 assigned on January 2024. The practitioner's primary taxonomy code is 261QD0000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Dr. Leah Nicole Clancy Dds (Owner)

NPI: 1255102323
Provider Name: GRAND AVENUE DENTAL CARE, LLC
Entity Type: Organization
Location Address: 1163 GRAND AVE HARTFORD, WI 53027
Location Phone: (262) 673-7826
Mailing Address: 2505 N 84TH ST WAUWATOSA, WI 53226
Mailing Phone: (708) 738-5438
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 01-09-2024
Last Update Date: 01-09-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Clinic/Center Dental
Taxonomy Code: 261QD0000X
Type: Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

UnitedHealthcare

Smile Now Arizona - No Waiting Period PPO - PPO
Smile Now Illinois - No Waiting Period PPO - PPO
Smile Now Michigan - No Waiting Period PPO - PPO
Smile Now Ohio - No Waiting Period PPO - PPO
Smile Now Tennessee - No Waiting Period PPO - PPO
Smile Now Texas- No Waiting Period Plan - PPO
Smile Now Utah - No Waiting Period PPO - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: DR. LEAH NICOLE CLANCY DDS
Authorized Official Title: OWNER
Authorized Official Phone: (708) 738-5438

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	2	5	5	1	0	2	3	2	3
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	2	10	5	2	0	4	3	4
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 0 + 5 + 2 + 0 + 4 + 3 + 4 + 24 = 47
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 47 = 3									3

The NPI number 1255102323 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.