MDC North Fondy SC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MDC NORTH FONDY SC

Practice address

825 Prospect Ave
North Fond Du Lac, WI 54937-1365

Phone

(920) 923-0310

NPI assigned

Jul 24, 2013

Organization subpart

No

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

Authorized official

Name

Dr. William Mauthe III

Title

Owner

Phone

(920) 948-6407

Specialties & licenses 1

Addresses

Practitioners 2

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

• Casey J Floros, D.D.S.

  • General Practice Dentistry
  • North Fond Du Lac, WI
  • NPI 1821430448
  NPD (past)
• Orvis Johnson, D.D.S

  • General Practice Dentistry
  • North Fond Du Lac, WI
  • NPI 1679596316
  NPD (past)

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1225470842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CAMELOT DR",
            "address_2": "SUITE 3",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358048",
            "telephone_number": "920-948-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 PROSPECT AVE",
            "city": "NORTH FOND DU LAC",
            "state": "WI",
            "postal_code": "549371365",
            "telephone_number": "920-923-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDC NORTH FONDY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "MAUTHE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-948-6407",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristine Karpen
• Julie Ann Kiefner, RN
• Teela Koski, PHARM.D.
• Jessica Marie Longdin, MS/CCC-SLP
• Tamara L Lyday, DO
• Steven Mui, DIPL.AC.
• North Fond Du Lac School District
• Orvis J. R. Johnson DDS,SC
• Quality Cab LLC
• Krystle L Schmitz, LPC

• General Practice Dentistry in North Fond Du Lac, WI
• Providers in North Fond Du Lac, 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 24, 2013; 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.