Organization Active NPI

E a Darkow DDS SC

  • General Practice Dentistry
  • Neenah, WI
National Provider Identifier
1861686958
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3205 Issued in WI
Legal business name
E A DARKOW DDS SC
Practice address
114 Haylett Street
Neenah, WI 54956
Phone
(920) 725-1111
Fax
(920) 725-1932
NPI assigned
Aug 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Authorized official

Name
Dr. Eugene A Darkow Jr., DDSNPI 1770730533
Title
Owner
Phone
(920) 725-1111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3205 WI Primary

Addresses

Primary practice location

114 Haylett Street
Neenah, WI 54956

Mailing address

114 Haylett Street
Neenah, WI 54956
Phone (920) 725-1111

Other identifiers 1

IdentifierTypeStateIssuer
33469800MedicaidWI

National Provider Directory

National Provider Directory

Locations

114 Haylett St
Neenah, WI 54956
Phone (920) 725-1111

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1861686958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HAYLETT STREET",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "54956",
            "telephone_number": "920-725-1111",
            "fax_number": "920-725-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 HAYLETT STREET",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "54956",
            "telephone_number": "920-725-1111",
            "fax_number": "920-725-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E A DARKOW DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-31",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "DARKOW",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-725-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33469800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.