NPIMap

Organization Active NPI

Smile Clinic, S.C.

  • Dentist
  • Manitowoc, WI
National Provider Identifier
1598878142
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1788 Issued in WI
Legal business name
SMILE CLINIC, S.C.
Practice address
1602 N 18TH St
Manitowoc, WI 54220-1858
Phone
(920) 682-9131
Fax
(920) 682-9799
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Scott Martin Behringer, DDSNPI 1215961685
Title
Owner
Phone
(920) 682-9131

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 1788 WI Primary

Addresses

Primary practice location

1602 N 18TH St
Manitowoc, WI 54220-1858

Mailing address

1602 N 18TH St
Manitowoc, WI 54220-1858
Phone (920) 682-9131

Other identifiers 3

IdentifierTypeStateIssuer
840836WOtherWIUNITED CONCORDIA
1788OtherWIDELTA DENTAL
389569136002OtherWIBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598878142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 N 18TH ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542201858",
            "telephone_number": "920-682-9131",
            "fax_number": "920-682-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 N 18TH ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542201858",
            "telephone_number": "920-682-9131",
            "fax_number": "920-682-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE CLINIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEHRINGER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-682-9131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "1788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "840836W",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "1788",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "389569136002",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.