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IDENTAL
NPI 1508316753
Dental Hygienist in Mount Pleasant, WI

Active since October 12, 2016
1320 S GREEN BAY RD, MOUNT PLEASANT, WI 53406(262) 223-0280(262) 223-0281 Get Directions Write a Review

NPPES record last updated: November 16, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 16, 2016, Oct 12, 2016 (2 updates tracked since 2016).

About Idental NPPES

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

IDENTAL (NPI 1508316753) is a healthcare organization registered as a dental hygienist in Mount Pleasant, Wisconsin and active in the NPI registry since October 2016. The organization lists Marian 'tracie' Clubb, Assistant Manager, as its authorized official.

NPPES Registry Identity

NPI1508316753
Entity TypeOrganization
Primary Taxonomy124Q00000X
Legal Business NameIDENTAL
Location Address1320 S GREEN BAY RDMount Pleasant, WI 53406-4402
Mailing Address1320 S Green Bay RdMount Pleasant, WI 53406-4402 · (262) 223-0280 · Fax (262) 223-0281
Phone(262) 223-0280
Fax(262) 223-0281
Organization SubpartNo
Authorized OfficialMarian 'tracie' ClubbAssistant Manager · (262) 223-0280
Enumeration DateOctober 12, 2016
Last NPPES UpdateNovember 16, 20162 updates tracked since enumeration
✔ NPI 1508316753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDental HygienistDental Providers
Taxonomy Code124Q00000X
License✔ Licensed in WI · 5279
Definition
An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary.
1320 S GREEN BAY RD, Mount Pleasant, WI 53406
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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 20

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

TAMI MARIE CHRISTENSEN RDH
Dental Hygienist
1320 S GREEN BAY RD
MOUNT PLEASANT, WI 53406
Racine County (262) 223-0280
DR. DAVID EUGENE NELSON DDS
Dentist
1320 S GREEN BAY RD
MOUNT PLEASANT, WI 53406
Racine County (262) 223-0280
JEANNIE LEDWITCH RDH
Dental Hygienist
1320 S GREEN BAY RD
MOUNT PLEASANT, WI 53406
Racine County (262) 223-0280
MRS. CHELSEA LOGAN CHATMAN-ZIERK RDH
Dental Hygienist
1320 S GREEN BAY RD
MOUNT PLEASANT, WI 53406
Racine County (262) 223-0280
NICOLE MARIE HARTMAN
Physical Therapy Assistant
1320 S GREEN BAY RD
MT PLEASANT, WI 53406
Racine County (262) 886-3431
ROXANN NAUMAN
Speech-Language Pathologist
1320 S GREEN BAY RD
MOUNT PLEASANT, WI 53406
Racine County (262) 886-3431
KRISTINE BLUMM
Dental Hygienist
1320 S GREEN BAY RD
MOUNT PLEASANT, WI 53406
Racine County (262) 223-0280
LATASHA MILLS
Dental Hygienist
1320 S GREEN BAY RD
MOUNT PLEASANT, WI 53406
Racine County (262) 223-0280

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 Idental's NPI number?

The NPI number for Idental is 1508316753. It was assigned to this organization in the NPPES registry on October 12, 2016.

Where is Idental located?

Idental is located at 1320 S Green Bay Rd, Mount Pleasant, WI 53406. The listed phone number is (262) 223-0280.

What is Idental's specialty?

The primary specialty registered for this NPI is Dental Hygienist with taxonomy code 124Q00000X.

When was this NPI record last updated?

The NPPES record for Idental was last updated on November 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.