Paul S Mantz, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6814-15 Issued in WI

Practice address

152 Woodlawn Dr
Shawano, WI 54166-2200

Phone

(715) 526-3314

NPI assigned

Nov 30, 2011

Last updated

Feb 3, 2022By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wolf River Dental LLC

  dba Zander Dental

  • Dental Clinic/Center
  • Shawano, WI
  • NPI 1144684002
  NPD (past)
• Zander Dental SC

  • Dentist
  • Shawano, WI
  • NPI 1073598165
  NPD (past)

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1093082331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541660270",
            "telephone_number": "715-526-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 WOODLAWN DR",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662200",
            "telephone_number": "715-526-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTZ",
        "first_name": "PAUL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-30",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6814-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1144684002",
            "identifier": "1144684002",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144684002",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adrienne Luebke, PHARMD
• Kelly Ann Maas, MSE, LPC, SAS
• Kelly M Mackowski, APNP
• Janson A Mancheski, OD
• Manor Care of Shawano Wi LLC (ManorCare Health Services - Shawano)
• Maple Lane Health & Rehabilitation Center LLC (D/B/a Atrium Post Acute Care of Shawano at Maple Lane)
• Katie Marie Marquardt
• Tamara C Martens, LPN
• Michael Mattes
• Mary Margaret McCoy, P.A

• General Practice Dentistry in Shawano, WI
• Providers in Shawano, 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 Feb 3, 2022; 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.