John Berton Luther, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

5588-015 Issued in WI

Practice address

821 E 1St Ave
Suite 3
Appleton, WI 54911-1501

Phone

(920) 734-9148

Fax

(920) 734-8710

NPI assigned

Nov 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Timbercrest Dental Center, S.C.

  • Dental Clinic/Center
  • Appleton, WI
  • NPI 1356414114
  NPD (past) Authorized official

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1457424210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4082 N RICHMOND ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139704",
            "telephone_number": "920-734-9148",
            "fax_number": "920-734-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E 1ST AVE",
            "address_2": "SUITE 3",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111501",
            "telephone_number": "920-734-9148",
            "fax_number": "920-734-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTHER",
        "first_name": "JOHN",
        "middle_name": "BERTON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5588-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "42-1583189",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boyd C Lumsden, M.D.
• Laura M Lundgren, PA C
• Kristin K Lundine, APNP
• Paul Phillip Lundine, D.D.S.
• Suzanne Mary Luniak, RPH
• Lutheran Social Services of Wisconsin and Upper Michigan, Inc.
• Ellen J. Lutz, L.P.C.
• Luxottica of America Inc
• Luxottica of America Inc.
• Luxottica of America Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; 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.