Scott Howard Nettum, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5001450 Issued in WI

Practice address

6729 Lake Road
Windsor, WI 53598-0000

Phone

(608) 846-5407

Fax

(608) 846-2493

NPI assigned

Apr 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962626077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6729 LAKE ROAD",
            "city": "WINDSOR",
            "state": "WI",
            "postal_code": "535980000",
            "telephone_number": "608-846-5407",
            "fax_number": "608-846-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6729 LAKE ROAD",
            "city": "WINDSOR",
            "state": "WI",
            "postal_code": "535980000",
            "telephone_number": "608-846-5407",
            "fax_number": "608-846-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTUM",
        "first_name": "SCOTT",
        "middle_name": "HOWARD",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• S A Khan, D.D.S.
• Keith Klinger
• Cassondra Lynn Kovach, MD
• Kristina Marie Kurtz
• Sandra McCloskey
• Bray Landon Plomb, DC
• Premise Health of Wisconsin Medical SC (Kwik Trip Center for Health, DeForest)
• Jeremy Quick, D.C.
• Cerys Ridd
• Kailaaya-Marie Romo

• General Practice Dentistry in Windsor, WI
• Providers in Windsor, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.