NPIMap

Organization Active NPI

MDC Mauston SC

  • General Practice Dentistry
  • Mauston, WI
National Provider Identifier
1831500875
Registry record updated May 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MDC MAUSTON SC
Practice address
205 Division St Ste B
Mauston, WI 53948-2110
Phone
(608) 847-5572
NPI assigned
May 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2014

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

Authorized official

Name
Dr. William C Mauthe III, D.D.S.
Title
Owner
Phone
(920) 921-1244

Specialties & licenses 1

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

Addresses

Primary practice location

205 Division St Ste B
Mauston, WI 53948-2110

Mailing address

54 E 1St St
Fond Du Lac, WI 54935-4204

Other names 1

  • CASTLE ROCK DENTAL Doing business as

National Provider Directory

National Provider Directory

Locations

205 Division St
Ste B
Mauston, WI 53948
Phone (608) 847-5572

NPI Registry JSON

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399939200000",
    "number": "1831500875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 E 1ST ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 DIVISION ST STE B",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539482110",
            "telephone_number": "608-847-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDC MAUSTON SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-13",
        "last_updated": "2014-05-13",
        "status": "A",
        "authorized_official_last_name": "MAUTHE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-921-1244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CASTLE ROCK DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mauston, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; 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.