Paul Francis Popelka, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3400W Issued in WI

Practice address

2310 E Evergreen Dr
Suite a
Appleton, WI 54913-7404

Phone

(920) 734-0601

Fax

(920) 734-9159

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Evergreen Dental, SC

  • General Practice Dentistry
  • Appleton, WI
  • NPI 1851433114
  NPD (past) Authorized official

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083756332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 E EVERGREEN DR",
            "address_2": "SUITE A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137404",
            "telephone_number": "920-734-0601",
            "fax_number": "920-734-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 E EVERGREEN DR",
            "address_2": "SUITE A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137404",
            "telephone_number": "920-734-0601",
            "fax_number": "920-734-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPELKA",
        "first_name": "PAUL",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3400W",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Alan Pomplun, PA-C
• Lindsey Leanna Pomputis
• Eve Lyn Pomrening, APNP
• Rachel Pontius, OTR
• Mark Garold Pontow
• Amy Poppy, PHARMD
• Angela Porcelli, APNP
• Ann K Porretto-Loehrke, PT, DPT, CHT, COMT
• Lisa Marie Portmann, LCSW SAC
• Lori Poss, NP

• General Practice Dentistry in Appleton, WI
• Providers in Appleton, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.