Robert H Southworth DDS SC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5001628-015 Issued in WI

Legal business name

ROBERT H SOUTHWORTH DDS SC

Practice address

609 Jackson St
Wausau, WI 54403-5550

Phone

(715) 842-1935

Fax

(715) 842-0334

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Robert Hurd Southworth, DDSNPI 1982998381

Title

President Owner

Phone

(715) 842-1935

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Hurd Southworth, D.D.S.

  • General Practice Dentistry
  • Wausau, WI
  • NPI 1982998381
  NPD (past) Authorized official

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841309697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 JACKSON ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035550",
            "telephone_number": "715-842-1935",
            "fax_number": "715-842-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 JACKSON ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035550",
            "telephone_number": "715-842-1935",
            "fax_number": "715-842-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT H SOUTHWORTH DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOUTHWORTH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "HURD",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "715-842-1935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001628-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin E Rist, MD
• Heather Ritter, O.D.
• Christina L Rivay, RN
• River Hawk Healthcare LLC
• David Clark Robare, RN
• Debra Roberts, SAC, LPC
• Mary K Roble, MSN NP
• Cheryl Rocheleau, OTR/L
• Rock Point Psychology LLC
• Alanis Nicole Rodriguez Colon, PHARMD

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