NPIMap

Organization Active NPI

Terry L. Kippa DDS SC

  • Endodontics
  • Oshkosh, WI
National Provider Identifier
1487812855
Registry record updated Jun 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
4375-015 Issued in WI
Legal business name
TERRY L. KIPPA DDS SC
Practice address
600 S Main St
Oshkosh, WI 54902-6074
Phone
(920) 233-8882
Fax
(920) 303-2736
NPI assigned
Jun 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2008

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

Authorized official

Name
Dr. Gordon Dean Korthals, DDSNPI 1235271792
Title
Corporate President
Phone
(920) 233-8882

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 4375-015 WI Primary

Addresses

Primary practice location

600 S Main St
Oshkosh, WI 54902-6074

Mailing address

600 S Main St
Oshkosh, WI 54902-6074
Phone (920) 233-8882

Other names 1

  • Terry L. Kippa, DDS and Gordon D. Korthals, DDS Doing business as

National Provider Directory

National Provider Directory

Locations

600 S Main St
Oshkosh, WI 54902
Phone (920) 233-1773

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1212278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212278400000",
    "number": "1487812855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S MAIN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549026074",
            "telephone_number": "920-233-8882",
            "fax_number": "920-303-2736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S MAIN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549026074",
            "telephone_number": "920-233-8882",
            "fax_number": "920-303-2736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY L. KIPPA DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-01",
        "last_updated": "2008-06-01",
        "status": "A",
        "authorized_official_last_name": "KORTHALS",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "CORPORATE PRESIDENT",
        "authorized_official_telephone_number": "920-233-8882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "WI",
            "license": "4375-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Terry L. Kippa, DDS and Gordon D. Korthals, DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2008; 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.