John J. Rydlewicz, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5557-015 Issued in WI

Practice address

5395 Michaels Dr
Appleton, WI 54913-8447

Phone

(920) 739-1214

Fax

(920) 739-5855

NPI assigned

Oct 12, 2006

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Oral & Maxillofacial Surgery Fox Cities, S.C.

  • Durable Medical Equipment & Medical Supplies
  • Appleton, WI
  • NPI 1154555373
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1992895031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5395 MICHAELS DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138447",
            "telephone_number": "920-739-1214",
            "fax_number": "920-739-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5395 MICHAELS DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138447",
            "telephone_number": "920-739-1214",
            "fax_number": "920-739-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDLEWICZ",
        "first_name": "JOHN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "5557-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Lee Ruppel, LMT
• Wayne J Rusin, MD
• Kristen N Russell, APNP
• Shayla Russell
• Amanda Rose Ryan, DMD
• Jennifer Rose Rydzewski
• Aprill E Rykal, DC
• Jeanine Rae Rysewyk, MAC LPC
• S H Chien MD SC
• S-H Opco Fox River, LLC

• Oral and Maxillofacial Surgery (Dentist) in Appleton, WI
• Providers in Appleton, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.