Katherine Su, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6001848-15 Issued in WI

Practice address

130 N Fond Du Lac Ave
Campbellsport, WI 53010-2787

Phone

(920) 533-8512

NPI assigned

Jun 18, 2025

Last updated

Jun 18, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Campbellsport Family Dentistry, LLC

  dba Campbellsport Family Dentistry

  • Dental Clinic/Center
  • Campbellsport, WI
  • NPI 1073368254
  NPD

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

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1396631982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N FOND DU LAC AVE",
            "city": "CAMPBELLSPORT",
            "state": "WI",
            "postal_code": "530102787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N FOND DU LAC AVE",
            "city": "CAMPBELLSPORT",
            "state": "WI",
            "postal_code": "530102787",
            "telephone_number": "920-533-8512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "KATHERINE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001848-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• School Sisters of St. Francis-St. Joseph Convent
• Tarah Smith
• Amie Jo Steger, APNP
• Deborah K Stocker, LPN
• Calyn Sue Strobel, RN
• Transtar Medical LTD.
• Dean William Uelmen, D.D.S.
• Village Apothecary Inc (The Village Apothecary)
• Village of Campbellsport (Campbellsport Vol Fire Dept)
• Lynn Wernicke, LPN

• Dentist in Campbellsport, WI
• Providers in Campbellsport, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.