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RANDOM LAKE DENTISTRY, INC
NPI 1982421046
Clinic/Center - Dental in Random Lake, WI

Active since September 20, 2024
37 HICKORY DR, RANDOM LAKE, WI 53075(920) 994-4367 Get Directions Write a Review

NPPES record last updated: September 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Random Lake Dentistry, Inc NPPES

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

RANDOM LAKE DENTISTRY, INC (NPI 1982421046) is a healthcare organization registered as a dental in Random Lake, Wisconsin and active in the NPI registry since September 2024. The organization lists Hooman Abdolisereshki, Owner, as its authorized official.

NPPES Registry Identity

NPI1982421046
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameRANDOM LAKE DENTISTRY, INC
Location Address37 HICKORY DRRandom Lake, WI 53075-1675
Mailing Address62 S Pleasant View RdPlymouth, WI 53073-4954 · (920) 892-8466 · Fax (920) 892-8467
Phone(920) 994-4367
Organization SubpartNo
Authorized OfficialHooman AbdolisereshkiOwner · (920) 892-8466
Enumeration DateSeptember 20, 2024
NPPES CertifiedSeptember 20, 2024
✔ NPI 1982421046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
37 HICKORY DR, Random Lake, WI 53075
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Other Providers at the Same Location NPPES

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

GENERATIONS FAMILY DENTAL CARE-RANDOM LAKE, LLC
Dentist (General Practice)
37 HICKORY DR
RANDOM LAKE, WI 53075
Sheboygan County (920) 994-4367

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 Random Lake Dentistry, Inc's NPI number?

The NPI number for Random Lake Dentistry, Inc is 1982421046. It was assigned to this organization in the NPPES registry on September 20, 2024.

Where is Random Lake Dentistry, Inc located?

Random Lake Dentistry, Inc is located at 37 Hickory Dr, Random Lake, WI 53075. The listed phone number is (920) 994-4367.

What is Random Lake Dentistry, Inc'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 Random Lake Dentistry, Inc was last updated on September 20, 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.