Organization
SHOPTIKAL LLC
Active
Other names
Shopko Optical 4323
Organization subpart
No
Provider details
NPI number
Authorized official
DIRK-JAN HEHENKAMP (CEO)
(920) 429-7285
Entity
Organization
Contact information
Practice address
8510 E 96TH ST STE B, FISHERS, IN 46037-9761
(920) 429-2211
Mailing address
PO BOX 19060, GREEN BAY, WI 54307-9060
(920) 429-7285
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
06/12/2026
Last updated
07/20/2026
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