Theresa Adamczyk, DDS
Individual provider Active NPI General Practice Dentistry · Oshkosh, WI
NPI 1962882308 · NPPES record last updated May 15, 2024
Key facts
- NPI
- 1962882308
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 1001079-15 (WI)
- Practice address
- 550 City Ctr
Oshkosh, WI 54901-4830 - Phone
- (920) 731-7445
- Fax
- (920) 651-3485
- NPI assigned
- Jun 1, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160407001498 | WI | Order and Referring Only - Other (Non-Physician) | 6305144346 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1001079-15 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Partnership Community Health Center, Inc | Past | Accepting new patients | |
| Partnership Community Health Center, Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1001079-15 | WI | Yes |
Addresses
Primary practice location
550 City Ctr
Oshkosh, WI 54901-4830
Mailing address
5337 W Grande Market Dr
Appleton, WI 54913-8442
Phone (920) 731-7445
Other practice location 1
825 W Fulton St
Waupaca, WI 54981-1471
Phone (920) 731-7445
Other practice location 2
5471 W Waterford Ln
Appleton, WI 54913-8510
Phone (920) 731-7445
Other practice location 3
5337 W Grande Market Dr
Appleton, WI 54913-8442
Phone (920) 731-7445
Other providers in Oshkosh, WI
- Greta Am Aberle
- Rami K Abumasmah
- Actra Rehabilitation Associates Inc
- Alan Randy Acuna
- Abdulmajid Adam
- Samantha Adams
- Paul A. Adamski
- Adaptive Counseling LLC
- Advance Therapy Center Inc
- Advanced Care Smile Center SC
All providers in Oshkosh, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.