Individual provider Active NPI

Sean M McLuen, DDS

  • General Practice Dentistry
  • Menasha, WI
National Provider Identifier
1851612899
Registry record updated Jun 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1001073-15 Issued in WI
Practice address
1431 Province Ter
Menasha, WI 54952-7003
Phone
(920) 968-1900
NPI assigned
Jun 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 25459 TX
General Practice Dentistry 1223G0001X 1001073-15 WI Primary

Addresses

Primary practice location

1431 Province Ter
Menasha, WI 54952-7003

Mailing address

181 S Riverheath Way Apt 212
Appleton, WI 54915-8404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160316001205 WI Order and Referring Only - DentistPractitioner - Dentist 4981900073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25459TXMDGeneral Practice Dentistry
1001073-15WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Menasha Family Dental LLC CurrentSince Jun 8, 2025 Accepting new patients
Depas Family Dental Care, S. C. General Practice PastSince Jun 8, 2025 Accepting new patients
Dental Associates LTD of Wisconsin General Practice PastSince Mar 1, 2023 Accepting new patients
Algoma Fama Dental LLC PastSince Aug 25, 2024 Accepting new patients

Locations

1431 Province Ter
Menasha, WI 54952
Phone (920) 968-1900

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748736000000",
    "number": "1851612899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 S RIVERHEATH WAY APT 212",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549158404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 PROVINCE TER",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549527003",
            "telephone_number": "920-968-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLUEN",
        "first_name": "SEAN",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-14",
        "last_updated": "2025-06-01",
        "certification_date": "2025-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25459",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001073-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menasha, WI

Sources for this page

Verify at the official NPI Registry.