OrganizationActive
Upper Lakes Dental, LLC
NPI 1124580352 · Dental Clinic/Center · Winneconne, WI
Provider details
- NPI number
- 1124580352
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ryan Gonzalez, Owner(920) 582-0688
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
908 E Main St Ste C
Winneconne, WI 54986-9672
Phone: (920) 582-0688
Street-level locationGet directions
Mailing address
Po Box 369
Winneconne, WI 54986-0369
Registry dates
- Enumerated
- 2019-04-05
- Last updated
- 2019-04-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.