Provider Demographics
NPI:1144116690
Name:VOGEL, RENEE (DDS)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:VOGEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 LAKE SHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:WAUCONDA
Mailing Address - State:IL
Mailing Address - Zip Code:60084-1523
Mailing Address - Country:US
Mailing Address - Phone:224-406-4463
Mailing Address - Fax:
Practice Address - Street 1:1525 FAIRWAY LN
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-5000
Practice Address - Country:US
Practice Address - Phone:262-723-3296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6001849-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice