Organization Active NPI

Tenor Family Dentistry of Appleton

Doing business as Advanced Care Smile Center of Appleton

  • Dentist
  • Appleton, WI
National Provider Identifier
1063775377
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
TENOR FAMILY DENTISTRY OF APPLETON
Doing business as
Advanced Care Smile Center of Appleton
Practice address
2600 N Richmond St
Appleton, WI 54911-1956
Phone
(920) 730-0400
NPI assigned
Jun 21, 2012
Last updated
Jun 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Authorized official

Name
Rebecca Lynn Bergene
Title
Chief Operating Officer
Phone
(920) 860-9252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

2600 N Richmond St
Appleton, WI 54911-1956

Mailing address

850 Elm Grove Rd Ste 25
Elm Grove, WI 53122-2527
Phone (920) 860-9252

Other names 1

  • Advanced Care Smile Center of Appleton Doing business as

National Provider Directory

National Provider Directory

Locations

2600 N Richmond St
Appleton, WI 54911
Phone (920) 730-0400

850 Elm Grove Rd
Ste 25
Elm Grove, WI 53122

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": "1340236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340236800000",
    "number": "1063775377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 ELM GROVE RD STE 25",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222527",
            "telephone_number": "920-860-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N RICHMOND ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111956",
            "telephone_number": "920-730-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENOR FAMILY DENTISTRY OF APPLETON",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-06-21",
        "status": "A",
        "authorized_official_last_name": "BERGENE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "920-860-9252"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Care Smile Center of Appleton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.