Timbercrest Dental Center, S.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5588-015 Issued in WI

Legal business name

TIMBERCREST DENTAL CENTER, S.C.

Practice address

821 E 1St Ave
Suite 3
Appleton, WI 54911-1501

Phone

(920) 734-9148

Fax

(920) 734-8710

NPI assigned

Nov 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Berton Luther, D.D.S.NPI 1457424210

Title

President

Phone

(920) 734-9148

Specialties & licenses 1

Addresses

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.

• John Berton Luther, D.D.S.

  • Dentist
  • Appleton, WI
  • NPI 1457424210
  NPD (past) Authorized official

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356414114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 E 1ST AVE",
            "address_2": "SUITE 3",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111501",
            "telephone_number": "920-734-9148",
            "fax_number": "920-734-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E 1ST AVE",
            "address_2": "SUITE 3",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111501",
            "telephone_number": "920-734-9148",
            "fax_number": "920-734-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMBERCREST DENTAL CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUTHER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "BERTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-734-9148",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WI",
            "license": "5588-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maggie Jo Tienor, M.S., CF-SLP
• Paige Kristine Tierney, DMD
• Leann Tilden, RN,BSN,CDE
• Catherine Tilkens
• Cassandra Timmers, LAT
• Timothy L. Galow, D.D.S., S.C.
• TLC Rides LLC
• Cassandra M Toeppler, MSN, APNP
• David A Toivonen, M.D.

• Dental Clinic/Center in Appleton, WI
• Providers in Appleton, WI by specialty
• Dental Clinic/Center in Wisconsin

• 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.