Healthcare Provider Details

I. General information

NPI: 1710530217
Provider Name (Legal Business Name): KIMBERLY ANNE HOERNING DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY ANNE CROWLEY DDS

II. Dates (important events)

Enumeration Date: 07/23/2019
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 S. ONEIDA STREET
GREEN BAY WI
54304-5243
US

IV. Provider business mailing address

2450 S. ONEIDA STREET
GREEN BAY WI
54304-5243
US

V. Phone/Fax

Practice location:
  • Phone: 920-499-6244
  • Fax:
Mailing address:
  • Phone: 920-499-6244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number1002157-15
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1002157-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: