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EVERGREEN DENTAL PARTNERS LLC
NPI 1871329292
Clinic/Center - Dental in Appleton, WI

Active since September 11, 2024
2310 E EVERGREEN DR STE A, APPLETON, WI 54913(608) 345-1410 Get Directions Write a Review

NPPES record last updated: September 11, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Evergreen Dental Partners Llc NPPES

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

EVERGREEN DENTAL PARTNERS LLC (NPI 1871329292), doing business as Evergreen Dental, is a healthcare organization registered as a dental in Appleton, Wisconsin and active in the NPI registry since September 2024. The organization lists Jacob M Hustad, Dentist, as its authorized official.

NPPES Registry Identity

NPI1871329292
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameEVERGREEN DENTAL PARTNERS LLC
Location Address2310 E EVERGREEN DR STE AAppleton, WI 54913-7405
Mailing Address2310 E Evergreen Dr Ste AAppleton, WI 54913-7405 · (608) 345-1410
Phone(608) 345-1410
Organization SubpartNo
Authorized OfficialJacob M HustadDentist · (608) 345-1410
Enumeration DateSeptember 11, 2024
NPPES CertifiedSeptember 11, 2024
✔ NPI 1871329292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
2310 E EVERGREEN DR STE A, Appleton, WI 54913
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Other Names 1

Doing Business AsEvergreen Dental

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 Evergreen Dental Partners LLC's NPI number?

The NPI number for Evergreen Dental Partners LLC is 1871329292. It was assigned to this organization in the NPPES registry on September 11, 2024. The provider is doing business as Evergreen Dental.

Where is Evergreen Dental Partners LLC located?

Evergreen Dental Partners LLC is located at 2310 E Evergreen Dr Ste A, Appleton, WI 54913. The listed phone number is (608) 345-1410.

What is Evergreen Dental Partners 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 Evergreen Dental Partners LLC was last updated on September 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.