Individual provider Active NPI

Perry M. Menos, D.D.S.

  • General Practice Dentistry
  • Appleton, WI
National Provider Identifier
1891787545
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3002 Issued in WI
Practice address
760 W Northland Ave
Appleton, WI 54914-1425
Phone
(920) 731-7717
Fax
(920) 733-6014
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3002 WI Primary

Addresses

Primary practice location

760 W Northland Ave
Appleton, WI 54914-1425

Mailing address

760 W Northland Ave
Appleton, WI 54914-1425
Phone (920) 731-7717

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
I20170323000367 WI Order and Referring Only - DentistPractitioner - Dentist 2769701929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3002WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Dental Center PastSince Sep 25, 2022 Accepting new patients

Organizations & group practices 1

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1891787545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 W NORTHLAND AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141425",
            "telephone_number": "920-731-7717",
            "fax_number": "920-733-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 W NORTHLAND AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141425",
            "telephone_number": "920-731-7717",
            "fax_number": "920-733-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENOS",
        "first_name": "PERRY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.