CM Romenesko DDS SC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CM ROMENESKO DDS SC

Practice address

2510 E Evergreen Dr
Appleton, WI 54913

Phone

(920) 739-7848

NPI assigned

Mar 1, 2022

Organization subpart

No

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

Authorized official

Name

Kendall A Butler

Title

Business Manager

Phone

(920) 739-7848

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Richard L. Romenesko DDS, SC Former legal business name

Locations

Practitioners 3

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

• Benjamin Joseph Romenesko, D.D.S.

  • General Practice Dentistry
  • Appleton, WI
  • NPI 1154769529
  NPD (past)
• Michael Gavin Romenesko, DDS

  • General Practice Dentistry
  • Appleton, WI
  • NPI 1437338720
  NPD (past)
• Richard Lee Romenesko Sr., D.D.S.

  • Dentist
  • Appleton, WI
  • NPI 1972675049
  NPD (past)

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1558017459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 E. EVERGREEN DRIVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54913",
            "telephone_number": "920-739-7848",
            "fax_number": "920-903-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 E EVERGREEN DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54913",
            "telephone_number": "920-739-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CM ROMENESKO DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "KENDALL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "920-739-7848"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI DR CALLIE ROMENESKO",
            "identifier": "1215124862",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Richard L. Romenesko DDS, SC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kathleen Anne Clarke
• Kendra Clayton
• Tyler Clearwater, APSW
• Shirley Louise Clemmons, BC-HIS
• Cloverleaf Counseling, LLC
• Cmwl2
• Thomas G Cody
• Michelle A Coenen, RN
• Steven Ronald Coenen, MD
• Carol Jean Cole, RN

• 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 Mar 1, 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.