NPIMap

Organization Active NPI

Oakpark Dental

  • General Practice Dentistry
  • Oshkosh, WI
National Provider Identifier
1386715662
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4060 Issued in WI
Legal business name
OAKPARK DENTAL
Practice address
450 N Koeller St
Oshkosh, WI 54902-4111
Phone
(920) 235-5503
Fax
(920) 235-5527
NPI assigned
Nov 10, 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
Genie Kuble
Title
Contact Officer
Phone
(920) 450-0157

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4060 WI Primary

Addresses

Primary practice location

450 N Koeller St
Oshkosh, WI 54902-4111

Mailing address

450 N Koeller St
Oshkosh, WI 54902-4111
Phone (920) 235-5503

National Provider Directory

National Provider Directory

Locations

450 N Koeller St
Oshkosh, WI 54902
Phone (920) 235-5503

Practitioners & affiliated clinicians

Practitioners 5

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": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386715662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N KOELLER ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549024111",
            "telephone_number": "920-235-5503",
            "fax_number": "920-235-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N KOELLER ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549024111",
            "telephone_number": "920-235-5503",
            "fax_number": "920-235-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKPARK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUBLE",
        "authorized_official_first_name": "GENIE",
        "authorized_official_title_or_position": "CONTACT OFFICER",
        "authorized_official_telephone_number": "920-450-0157"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, 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.