Provider Demographics
NPI:1356970370
Name:STRIGENZ, NATHANIEL ANTHONY
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:ANTHONY
Last Name:STRIGENZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4932 BULLIS FARM RD APT 212
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-2720
Mailing Address - Country:US
Mailing Address - Phone:920-904-7454
Mailing Address - Fax:
Practice Address - Street 1:205 E WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-4207
Practice Address - Country:US
Practice Address - Phone:414-778-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1002411-151223G0001X
390200000X
CO002050421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program