Glacier Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5396 Issued in WI

Legal business name

GLACIER DENTAL

Practice address

1840 Evans St
Oshkosh, WI 54901-2362

Phone

(920) 235-3251

Fax

(920) 235-3567

NPI assigned

Apr 23, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Wyn Steckbauer, D.M.D.NPI 1841391109

Title

Dentist

Phone

(920) 235-3251

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wyn Steckbauer, D.M.D.

  • Dentist
  • Oshkosh, WI
  • NPI 1841391109
  Authorized official Same address or phone

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649498528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 EVANS STREET",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549022362",
            "telephone_number": "920-235-3251",
            "fax_number": "920-235-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 EVANS ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549012362",
            "telephone_number": "920-235-3251",
            "fax_number": "920-235-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STECKBAUER",
        "authorized_official_first_name": "WYN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "920-235-3251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1841391109",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genesis Behavioral Services, Inc
• Timothy F George, D.C.
• Anita I Gheller-Rigoni, DO
• Marshall F Gibbs, DDS
• Cathy Gibson, RPH
• Samantha Glenn
• Veronica Glodowski
• Alyssa Anne Gloudemans, P.T.
• Kathryn Marie Glynn, M.D.
• Raven Gmach, LAT, ATC

• General Practice Dentistry in Oshkosh, WI
• Providers in Oshkosh, 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 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.