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MISHICOT DENTAL
NPI 1407006869
Dentist - General Practice in Mishicot, WI

Active since September 23, 2008
105 N PARK LN, MISHICOT, WI 54228(920) 755-2336 Get Directions Write a Review

NPPES record last updated: September 23, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mishicot Dental NPPES

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

MISHICOT DENTAL (NPI 1407006869) is a healthcare organization registered as a general practice in Mishicot, Wisconsin and active in the NPI registry since September 2008. The organization lists Jason Allen Thiel, President / Dentist, as its authorized official.

NPPES Registry Identity

NPI1407006869
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMISHICOT DENTAL
Location Address105 N PARK LNMishicot, WI 54228-9537
Mailing Address105 N Park LnMishicot, WI 54228-9537 · (920) 755-2336
Phone(920) 755-2336
Organization SubpartNo
Authorized OfficialJason Allen ThielPresident / Dentist · (920) 755-2336
Enumeration DateSeptember 23, 2008
✔ NPI 1407006869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in WI · 5096-015
Definition
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.
105 N PARK LN, Mishicot, WI 54228
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JASON ALLEN THIEL DDS
Dentist
105 N PARK LN
MISHICOT, WI 54228
Manitowoc County (920) 755-2336
DR. RONALD JOHN LESE DDS
Dentist
105 N PARK LN
MISHICOT, WI 54228
Manitowoc County (920) 755-2336

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 Mishicot Dental's NPI number?

The NPI number for Mishicot Dental is 1407006869. It was assigned to this organization in the NPPES registry on September 23, 2008.

Where is Mishicot Dental located?

Mishicot Dental is located at 105 N Park Ln, Mishicot, WI 54228. The listed phone number is (920) 755-2336.

What is Mishicot Dental's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Mishicot Dental was last updated on September 23, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.