MDC Bellevue, L.L.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MDC BELLEVUE, L.L.C.

Practice address

2040 Central CT
Green Bay, WI 54311-6276

Phone

(920) 468-0504

NPI assigned

Mar 2, 2016

Organization subpart

No

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

Authorized official

Name

Dr. William C Mauthe III, D.D.S.

Title

Owner

Phone

(920) 921-1244

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• David Jerome Degrave, DDS

  • General Practice Dentistry
  • Green Bay, WI
  • NPI 1518981711
  NPD (past)
• Christopher Patrick Laws, DDS

  • Dentist
  • Green Bay, WI
  • NPI 1770532830
  NPD (past)
• Elese McClarie, DMD

  • General Practice Dentistry
  • Little Chute, WI
  • NPI 1588183404
  NPD (past)

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1396105474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SHEBOYGAN ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354281",
            "telephone_number": "920-922-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 CENTRAL CT",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116276",
            "telephone_number": "920-468-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDC BELLEVUE, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "MAUTHE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-921-1244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy C McNeill, LMT
• Richard Kevin McNutt, MD
• Isaac McQuay
• Lacey McRoy, PT
• Jean Marie McWey, M.S. CCC-SLP
• Jacob Mead
• Robert Charles Mead, MD
• Meadowbrook Smiles
• Kathryn Meadowcroft, FNP
• Medequipment & Supplies

• General Practice Dentistry in Green Bay, WI
• Providers in Green Bay, 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 Mar 2, 2016; 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.