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MT CALVARY DENTAL LLC
NPI 1780288977
Clinic/Center - Dental in Mount Calvary, WI

Active since November 28, 2020
100 EVERGREEN RD, MOUNT CALVARY, WI 53057(920) 753-2771 Get Directions Write a Review

NPPES record last updated: November 28, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mt Calvary Dental Llc NPPES

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

MT CALVARY DENTAL LLC (NPI 1780288977) is a healthcare organization registered as a dental in Mount Calvary, Wisconsin and active in the NPI registry since November 2020. The organization lists Caitlin Bloomer, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1780288977
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameMT CALVARY DENTAL LLC
Location Address100 EVERGREEN RDMount Calvary, WI 53057-9726
Mailing Address3500 Woodview LnSaukville, WI 53080-1400 · (920) 645-1219
Phone(920) 753-2771
Organization SubpartNo
Authorized OfficialCaitlin BloomerOwner/dentist · (920) 645-1219
Enumeration DateNovember 28, 2020
NPPES CertifiedNovember 28, 2020
✔ NPI 1780288977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
100 EVERGREEN RD, Mount Calvary, WI 53057
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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.

AGNESIAN HEALTHCARE
Durable Medical Equipment & Medical Supplies
100 EVERGREEN RD
MOUNT CALVARY, WI 53057
Fond Du Lac County (920) 753-2311
JEFFREY A STRONG MD
Family Medicine
100 EVERGREEN RD
MOUNT CALVARY, WI 53057
Fond Du Lac County (920) 753-2311

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 Mt Calvary Dental LLC's NPI number?

The NPI number for Mt Calvary Dental LLC is 1780288977. It was assigned to this organization in the NPPES registry on November 28, 2020.

Where is Mt Calvary Dental LLC located?

Mt Calvary Dental LLC is located at 100 Evergreen Rd, Mount Calvary, WI 53057. The listed phone number is (920) 753-2771.

What is Mt Calvary 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 Mt Calvary Dental LLC was last updated on November 28, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.