Individual provider Active NPI

Erik Paul Skoe

  • Pediatric Dentistry
  • Green Bay, WI
National Provider Identifier
1932804192
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
6001701 Issued in WI
Practice address
430 Main St
Green Bay, WI 54301-5115
Phone
(920) 431-0345
NPI assigned
Apr 4, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 6001701 WI Primary

Addresses

Primary practice location

430 Main St
Green Bay, WI 54301-5115

Mailing address

11711 W Burleigh St
Wauwatosa, WI 53222-3196
Phone (414) 771-2345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6001701WIMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Associates LTD of Wisconsin Pediatric Dentistry CurrentSince Jul 22, 2025 Accepting new patients

Locations

430 Main St
Green Bay, WI 54301
Phone (920) 431-0345

11711 W Burleigh St
Wauwatosa, WI 53222
Phone (414) 771-2345

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": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1932804192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11711 W BURLEIGH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532223196",
            "telephone_number": "414-771-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MAIN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543015115",
            "telephone_number": "920-431-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOE",
        "first_name": "ERIK",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-04",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "6001701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.