Organization Active NPI

John W. Stilp, DDS, SC

  • Oral and Maxillofacial Surgery (Dentist)
  • Wausau, WI
National Provider Identifier
1063739589
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
500212 Issued in WI
Legal business name
JOHN W. STILP, DDS, SC
Practice address
3000 Westhill Drive
Suite 301
Wausau, WI 54401
Phone
(715) 845-4511
Fax
(715) 845-1898
NPI assigned
Apr 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Authorized official

Name
Dr. John William Stilp, DDS
Title
President
Phone
(715) 845-4511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 500212 WI Primary

Addresses

Primary practice location

3000 Westhill Drive
Suite 301
Wausau, WI 54401

Mailing address

3000 Westhill Drive
Suite 301
Wausau, WI 54401
Phone (715) 845-4511

National Provider Directory

National Provider Directory

Locations

438 Edison St
Antigo, WI 54409
Phone (715) 432-4565

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1063739589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 WESTHILL DRIVE",
            "address_2": "SUITE 301",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54401",
            "telephone_number": "715-845-4511",
            "fax_number": "715-845-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 WESTHILL DRIVE",
            "address_2": "SUITE 301",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54401",
            "telephone_number": "715-845-4511",
            "fax_number": "715-845-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN W. STILP, DDS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "STILP",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-845-4511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "500212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.