Individual provider Active NPI

Nikita George Tongas, DDS

  • General Practice Dentistry
  • Waupaca, WI
National Provider Identifier
1609563832
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6001080-15 Issued in WI
Practice address
825 W Fulton St
Waupaca, WI 54981-1471
Phone
(920) 731-7445
NPI assigned
Apr 19, 2023
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6001080-15 WI
General Practice Dentistry 1223G0001X 6001080-15 WI Primary

Addresses

Primary practice location

825 W Fulton St
Waupaca, WI 54981-1471

Mailing address

5337 W Grande Market Dr
Appleton, WI 54913-8442

Other practice location 1

5337 W Grande Market Dr
Appleton, WI 54913
Phone (920) 731-7445

Other practice location 2

550 City Ctr
Oshkosh, WI 54901
Phone (920) 731-7445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6001080-15WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Partnership Community Health Center, Inc Past Accepting new patients
Partnership Community Health Center, Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1609563832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5337 W GRANDE MARKET DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 W FULTON ST",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811471",
            "telephone_number": "920-731-7445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5337 W Grande Market Dr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "54913",
            "country_code": "US",
            "telephone_number": "920-731-7445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 City Ctr",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "54901",
            "country_code": "US",
            "telephone_number": "920-731-7445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TONGAS",
        "first_name": "NIKITA",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-19",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001080-15",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001080-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waupaca, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.