Pack Janesville Dental, LLC.
NPI 1740679448ActiveOrganization· Dentist, General Practice· Janesville, WI
Dentist, General Practice in Janesville, Wisconsin, registered in NPPES in January 2015. The authorized official on file is Kim Van Camp, Provider Relations Specialist.
Overview
| NPI | 1740679448 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 19, 2015 |
| Last updated in NPPES | Jan 19, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 5001352 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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