CESA #11 RURAL HEALTH DENTAL CLINIC – NPI #1730390840
Clinic/Center

CESA #11 RURAL HEALTH DENTAL CLINIC is an AHC clinic located in MENOMONIE, WI. NPPES has assigned the NPI number 1730390840 to CESA #11 RURAL HEALTH DENTAL CLINIC on May 24, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 18 years ago on Aug 06, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CESA #11 RURAL HEALTH DENTAL CLINIC below.

NPI Profile for
CESA #11 RURAL HEALTH DENTAL CLINIC

NPI Number
1730390840
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CESA #11 RURAL HEALTH DENTAL CLINIC
Primary location
3375 KOTHLOW AVE.
SUITE 40
MENOMONIE, WI 54751
Phone: (715) 235-1573 Fax: (715) 235-2081
Mailing address
225 OSTERMANN DR
TURTLE LAKE, WI 54889-9191
Phone: (715) 986-2020 Fax: (715) 986-2041
Organization Subpart
No
Authorized Official
SHARON HAUGERUD
DIRECTOR
Phone: (715) 986-2020
Updated
Identifiers

Identifiers for CESA #11 RURAL HEALTH DENTAL CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDWI38389000
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)		 WI

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.