Evergreen Dental, SC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3400W Issued in WI

Legal business name

EVERGREEN DENTAL, SC

Practice address

2310 E Evergreen Dr
Suite a
Appleton, WI 54913-7404

Phone

(920) 734-0601

Fax

(920) 734-9159

NPI assigned

Feb 13, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Paul Francis Popelka, DDSNPI 1083756332

Title

Owner

Phone

(920) 734-0601

Specialties & licenses 1

Addresses

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.

• Paul Francis Popelka, DDS

  • General Practice Dentistry
  • Appleton, WI
  • NPI 1083756332
  NPD (past) Authorized official

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851433114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 E EVERGREEN DR",
            "address_2": "SUITE A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137404",
            "telephone_number": "920-734-0601",
            "fax_number": "920-734-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 E EVERGREEN DR",
            "address_2": "SUITE A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137404",
            "telephone_number": "920-734-0601",
            "fax_number": "920-734-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN DENTAL, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POPELKA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-734-0601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3400W",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa J Esser, AUDIOLOGIST
• Megan Marie Essler, RN
• Monica Lynne Eugenio
• Halee Evans
• Evergreen Dental Partners LLC (Evergreen Dental)
• Anna Evers, PT, DPT
• Michele Evers, RDH
• Megan M Everson, MD
• Evolve LLC
• Expressive Therapies LLC

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