Scott A. Rennicke, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2281 Issued in WI

Practice address

7604 W Mequon Rd
Mequon, WI 53097-3215

Phone

(262) 242-8929

NPI assigned

Nov 21, 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

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

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.

• Mequonctd1 LLC

  • Dentist
  • Mequon, WI
  • NPI 1588249148
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629143912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7604 W MEQUON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530973215",
            "telephone_number": "262-242-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7604 W MEQUON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530973215",
            "telephone_number": "262-242-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNICKE",
        "first_name": "SCOTT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "2281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Christine Reeves, BCBA
• Joseph P Regan, M.D.
• Kristen Regan
• Luke F Rehrauer, MD
• Nicole Reith
• Alexandra Reynolds
• Sheila A Reynolds
• Cynthia Rice, M.D.
• Richard a Haas MDSC
• Courtney B Richter, PA-C

• General Practice Dentistry in Mequon, WI
• Providers in Mequon, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.