Chad Randall Seubert, D.D.S

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

1001261 Issued in WI

Practice address

3164 Finger Rd
Green Bay, WI 54311-7602

Phone

(920) 471-0022

Fax

(920) 471-0755

NPI assigned

Apr 3, 2012

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Baycare Clinic LLP

  • Emergency Medicine Physician
  • Green Bay, WI
  • NPI 1588609648
  Medicare reassignment NPD
• New Oral & Facial Surgery, SC

  • Oral and Maxillofacial Surgery (Dentist)
  • Green Bay, WI
  • NPI 1609634351
  NPD Authorized official
• Baycare Clinic LLP

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1134490758

  Oral and Maxillofacial Surgery

  NPD

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1396001483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3164 FINGER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543117602",
            "telephone_number": "920-471-0022",
            "fax_number": "920-471-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3164 FINGER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543117602",
            "telephone_number": "920-471-0022",
            "fax_number": "920-471-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEUBERT",
        "first_name": "CHAD",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-03",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "362",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "1001261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Babak Serushan, M.D.
• Robert A Servais Jr., DC
• Katelyn Mae Servi, PTA
• Michael Servi, O.D.
• Sampoornima Setty, M.D.
• Daniel L Severance, DO
• Katrina Severance, DO
• Tracy Severson, PT
• Laura Sewall, PHARMD
• Amanda Jo Seyer, SLP

• Oral and Maxillofacial Surgery (Dentist) in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.