NPIMap

Organization Active NPI

Valley Endodontics LTD

  • Endodontics
  • Appleton, WI
National Provider Identifier
1992890198
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
VALLEY ENDODONTICS LTD
Practice address
1100 N Lynndale Drive
Appleton, WI 54914
Phone
(920) 731-4484
Fax
(920) 731-2889
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Starr William Clark, DDS
Title
Endodontist Partner
Phone
(920) 731-4484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

1100 N Lynndale Drive
Appleton, WI 54914

Mailing address

1100 N Lynndale Drive
Appleton, WI 54914
Phone (920) 731-4484

National Provider Directory

National Provider Directory

Locations

1100 N Lynndale Dr
Appleton, WI 54914
Phone (920) 731-4484

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992890198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N LYNNDALE DRIVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54914",
            "telephone_number": "920-731-4484",
            "fax_number": "920-731-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N LYNNDALE DRIVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54914",
            "telephone_number": "920-731-4484",
            "fax_number": "920-731-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY ENDODONTICS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STARR",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "ENDODONTIST PARTNER",
        "authorized_official_telephone_number": "920-731-4484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.