NPIMap

Organization Active NPI

Children's Dental Health Center, S.C.

  • Pediatric Dentistry
  • Appleton, WI
National Provider Identifier
1710968086
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
4586 Issued in WI
Legal business name
CHILDREN'S DENTAL HEALTH CENTER, S.C.
Practice address
W3132 Van Roy Rd
Appleton, WI 54915-3982
Phone
(920) 731-2566
Fax
(920) 731-7868
NPI assigned
Nov 14, 2005
Last updated
Aug 22, 2020By the provider in NPPES
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. Mark J Steinmetz, D.D.S., M.S.NPI 1922215151
Title
President
Phone
(920) 731-2566

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 4586 WI Primary

Addresses

Primary practice location

W3132 Van Roy Rd
Appleton, WI 54915-3982

Mailing address

W3132 Van Roy Rd
Appleton, WI 54915-3982
Phone (920) 731-2566

Other identifiers 3

IdentifierTypeStateIssuer
33744500MedicaidWI
33570700MedicaidWI
33732800MedicaidWI

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710968086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W3132 VAN ROY RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549153982",
            "telephone_number": "920-731-2566",
            "fax_number": "920-731-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3132 VAN ROY RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549153982",
            "telephone_number": "920-731-2566",
            "fax_number": "920-731-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTAL HEALTH CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEINMETZ",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-731-2566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "4586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33744500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33570700",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33732800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, 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.