Healthcare Provider Details

I. General information

NPI: 1134052426
Provider Name (Legal Business Name): PAIGE ELIZABETH VANDELINDER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1052 BEL AIRE CT BAY WI54304
GREEN BAY WI
54304-5014
US

IV. Provider business mailing address

840 ELEMENT WAY UNIT 425
GREEN BAY WI
54304-4640
US

V. Phone/Fax

Practice location:
  • Phone: 920-504-2862
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6002208
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: