NPIMap

Organization Active NPI

Affordable Dentures & Implants - Green Bay, S.C.

  • Dentist
  • Green Bay, WI
National Provider Identifier
1003460551
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
AFFORDABLE DENTURES & IMPLANTS - GREEN BAY, S.C.
Practice address
1800-C W. Mason Street
Green Bay, WI 54303
Phone
(920) 499-7159
NPI assigned
Aug 1, 2019
Last updated
Aug 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Petty, DDS
Title
Owner
Phone
(920) 499-7159

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

1800-C W. Mason Street
Green Bay, WI 54303

Mailing address

1800-C W. Mason Street
Green Bay, WI 54303
Phone (920) 499-7159

National Provider Directory

National Provider Directory

Locations

1800 W Mason St
Stop C
Green Bay, WI 54303
Phone (920) 499-7159

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564617600000",
    "number": "1003460551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800-C W. MASON STREET",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54303",
            "telephone_number": "920-499-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800-C W. MASON STREET",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54303",
            "telephone_number": "920-499-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES & IMPLANTS - GREEN BAY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-01",
        "last_updated": "2019-08-01",
        "status": "A",
        "authorized_official_last_name": "PETTY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-499-7159",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.