Individual provider Active NPI

Dale Melvin Scharine, D.D.S.

  • General Practice Dentistry
  • Appleton, WI
National Provider Identifier
1962538561
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1068G Issued in WI
Practice address
315 W Wisconsin Ave
Appleton, WI 54911-4355
Phone
(920) 733-4787
Fax
(920) 733-7176
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1068G WI Primary

Addresses

Primary practice location

315 W Wisconsin Ave
Appleton, WI 54911-4355

Mailing address

315 W Wisconsin Ave
Appleton, WI 54911-4355
Phone (920) 733-4787

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
I20150522001181 WI Order and Referring Only - DentistPractitioner - Dentist 4183944622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1068GWIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962538561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W WISCONSIN AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549114355",
            "telephone_number": "920-733-4787",
            "fax_number": "920-733-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W WISCONSIN AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549114355",
            "telephone_number": "920-733-4787",
            "fax_number": "920-733-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHARINE",
        "first_name": "DALE",
        "middle_name": "MELVIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1068G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.