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BLACK CREEK DENTAL LLC
NPI 1457716763
Dentist - General Practice in Black Creek, WI

Active since December 31, 2015
207 S MAIN ST, BLACK CREEK, WI 54106(920) 984-3315(920) 984-3317 Get Directions Write a Review

NPPES record last updated: December 31, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Black Creek Dental Llc NPPES

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

BLACK CREEK DENTAL LLC (NPI 1457716763) is a healthcare organization registered as a general practice in Black Creek, Wisconsin and active in the NPI registry since December 2015. The organization lists Thomas E Lornson, Owner, as its authorized official.

NPPES Registry Identity

NPI1457716763
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBLACK CREEK DENTAL LLC
Location Address207 S MAIN STBlack Creek, WI 54106-9742
Mailing AddressPo Box 255Black Creek, WI 54106-0255 · (920) 984-3315 · Fax (920) 984-3317
Phone(920) 984-3315
Fax(920) 984-3317
Organization SubpartNo
Authorized OfficialThomas E LornsonOwner · (920) 984-3315
Enumeration DateDecember 31, 2015
✔ NPI 1457716763 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 · 4932-15
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.
207 S MAIN ST, Black Creek, WI 54106
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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

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 Black Creek Dental LLC's NPI number?

The NPI number for Black Creek Dental LLC is 1457716763. It was assigned to this organization in the NPPES registry on December 31, 2015.

Where is Black Creek Dental LLC located?

Black Creek Dental LLC is located at 207 S Main St, Black Creek, WI 54106. The listed phone number is (920) 984-3315.

What is Black Creek Dental LLC'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 Black Creek Dental LLC was last updated on December 31, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.