NPIMap

Organization Active NPI

Feider, Tiboris & Bistan DDS SC

  • General Practice Dentistry
  • Sheboygan, WI
National Provider Identifier
1740392000
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FEIDER, TIBORIS & BISTAN DDS SC
Practice address
1630 N Taylor Dr
Sheboygan, WI 53081-1929
Phone
(920) 457-2255
Fax
(920) 458-0469
NPI assigned
Aug 31, 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
Ms. Ginny Fenner
Title
Administrator
Phone
(920) 457-2255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X WI Primary

Addresses

Primary practice location

1630 N Taylor Dr
Sheboygan, WI 53081-1929

Mailing address

1630 N Taylor Dr
Sheboygan, WI 53081-1929
Phone (920) 457-2255

National Provider Directory

National Provider Directory

Locations

1630 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 457-2255

Practitioners & affiliated clinicians

Practitioners 6

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740392000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 N TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811929",
            "telephone_number": "920-457-2255",
            "fax_number": "920-458-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 N TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811929",
            "telephone_number": "920-457-2255",
            "fax_number": "920-458-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEIDER, TIBORIS & BISTAN DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FENNER",
        "authorized_official_first_name": "GINNY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "920-457-2255",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, 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.