Active NPI
William C Mauthe, DDS
- General Practice Dentistry
- Fond Du Lac, WI
National Provider Identifier
1760628887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5000189
- Practice address
- 101 Camelot Dr Ste 3
Fond Du Lac, WI 54935-8048 - Phone
- (920) 921-1244
- Fax
- (920) 921-2192
- NPI assigned
- Dec 18, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5000189 | WI | Primary |
Addresses
Primary practice location
101 Camelot Dr Ste 3
Fond Du Lac, WI 54935-8048
Mailing address
101 Camelot Dr Ste 3
Fond Du Lac, WI 54935-8048
Phone (920) 921-1244
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5000189 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229558400000",
"number": "1760628887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 CAMELOT DR STE 3",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549358048",
"telephone_number": "920-921-1244",
"fax_number": "920-921-2192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CAMELOT DR STE 3",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549358048",
"telephone_number": "920-921-1244",
"fax_number": "920-921-2192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAUTHE",
"first_name": "WILLIAM",
"middle_name": "C",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-18",
"last_updated": "2008-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "5000189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.