NPIMap

Organization Active NPI

David J Emanuel DDS SC

  • Dentist
  • Appleton, WI
National Provider Identifier
1174683288
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3588 Issued in WI
Legal business name
DAVID J EMANUEL DDS SC
Practice address
1033 W College Ave
Suite 200
Appleton, WI 54914-5290
Phone
(920) 739-4246
Fax
(920) 739-4567
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
David John Emanuel, DDSNPI 1518919497
Title
Owner
Phone
(920) 739-4246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 3588 WI Primary

Addresses

Primary practice location

1033 W College Ave
Suite 200
Appleton, WI 54914-5290

Mailing address

1033 W College Ave
Suite 200
Appleton, WI 54914-5290
Phone (920) 739-4246

National Provider Directory

National Provider Directory

Locations

1033 W College Ave
Ste 200
Appleton, WI 54914
Phone (920) 739-4246

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174683288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 W COLLEGE AVE",
            "address_2": "SUITE 200",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549145290",
            "telephone_number": "920-739-4246",
            "fax_number": "920-739-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 W COLLEGE AVE",
            "address_2": "SUITE 200",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549145290",
            "telephone_number": "920-739-4246",
            "fax_number": "920-739-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID J EMANUEL DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EMANUEL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-739-4246",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "3588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.