Neighborhood Smiles Of Oconomowoc
Dentist, General Practice in Oconomowoc, WI. Organization (NPI-2).
NPI number1639455751
StatusActive
Last updated in NPPESNov 2, 2011
Details
- NPI
- 1639455751
- Entity type
- Organization (NPI-2)
- Legal business name
- Neighborhood Smiles Of Oconomowoc
- Organization subpart
- No
- Enumeration date
- Nov 2, 2011
- Last updated
- Nov 2, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
784 Summit AveOconomowoc, WI 53066-3838
Phone 509-953-5631
Mailing address
19408 W Williams Lake RdCheney, WA 99004-9742
Authorized official
Patti Sooy
Owner
5099535631
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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