Fox Valley Dental Center

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FOX VALLEY DENTAL CENTER

Practice address

760 W Northland Ave
Appleton, WI 54914-1425

Phone

(920) 731-7717

Fax

(920) 733-6014

NPI assigned

Sep 22, 2022

Last updated

Sep 22, 2022By 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. Katie Leah Hareid, DDSNPI 1972751923

Title

Owner/Member

Phone

(415) 307-6025

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Katie Leah Hareid, DDS

  • General Practice Dentistry
  • Eloy, AZ
  • NPI 1972751923
  NPD Authorized official
• Perry M. Menos, D.D.S.

  • General Practice Dentistry
  • Appleton, WI
  • NPI 1891787545
  NPD (past)

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1396468476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 KRAFT ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564988",
            "telephone_number": "415-307-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 W NORTHLAND AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141425",
            "telephone_number": "920-731-7717",
            "fax_number": "920-733-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "HAREID",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "LEAH",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "415-307-6025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1972751923",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fox River Assisted Living & Memory Care, LLC (Fox River)
• Fox River Nursing and Rehab Center LLC
• Fox River Periodontics SC
• Fox Run Dental, LLC
• Fox Valley Dental Assoc. LTD.
• Fox Valley Gastroenterology, S.C.
• Fox Valley Hematology & Oncology S C (Fox Valley Family Pharmacy)
• Fox Valley Hematology & Oncology, S.C.
• Fox Valley Hematology & Oncology, S.C.
• Fox Valley in-Home Care Inc.

• 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 Sep 22, 2022; 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.