APPLE CREEK ORAL SURGERY, SC (NPI# 1275753659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275753659 |
Entity Type | Organization |
Organization Name | APPLE CREEK ORAL SURGERY, SC |
Practice Address |
2410 East Evergreen Drive Appleton WI 54913 |
Mailing Address |
2410 E. Evergreen Drive Appleton WI 54913 |
Practice Telephone | 9208329500 |
Mailing Telephone | 9208329500 |
Enumeration Date | 2007-04-26 |
Last Update Date | 2020-08-22 |
Authorized Official Name | TIMOTHY J KOLL (PRESIDENT) |
Authorized Official Telephone | 9208329500 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
4243 | WI | Dental Providers |
Street Address |
2410 EAST EVERGREEN DRIVE |
City | APPLETON |
State | WI |
Zip Code | 54913 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457994584 | Pamela J Andersen | Music Therapist | 245 N. Metro Drive, Appleton, WI 54913 | 2019-10-22 |
1396387510 | Nancy Sibley | Technician | N4423 County Road Ee, Appleton, WI 54913 | 2019-10-09 |
1659872240 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 3801 N. Richmond Street, Grand Chute, WI 54913 | 2018-02-28 |
1780116244 | Alison Pelger | Physician Assistant | 3916 North Intertech Court, Appleton, WI 54913 | 2017-04-03 |
1316311905 | Lucy Bouressa | Specialist/Technologist | 2105 E. Enterprise Ave, 113, Appleton, WI 54913 | 2015-11-19 |
1992189989 | Brittany Reinke | Physical Therapist | Walking and Wheeling, LLC, W4652 Glenn Street, Appleton, WI 54913 | 2015-07-20 |
1902280092 | Costco Wholesale Corporation | Pharmacy | 5401 W Integrity Way, Grand Chute, WI 54913 | 2015-07-17 |
1942646849 | Richard Anthony Mauthe | Pharmacist | 5401 W. Integrity Way, Neenah, WI 54913 | 2013-05-17 |
1750622163 | Tonya Janelle Wilderman | Pharmacist | 1400 N Mccarthy Rd, Apt 2, Grand Chute, WI 54913 | 2013-03-10 |
1295938777 | Jenna Marie Kadlec | Physical Therapist | 3916 N. Intertech Court, Appleton, WI 54913 | 2007-06-11 |
Find all providers in zip 54913 |
Taxonomy Code | 1223P0106X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Pathology |
The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063951663 | Lmg Inc | Dentist | W3132 Van Roy Rd, Appleton, WI 54915-3982 | 2017-02-15 |
1154403194 | Timothy James Koll | Dentist | 2410 E. Evergreen Dr., Appleton, WI 54913-4913 | 2006-10-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497098255 | Matthew James Midtling | Dentist | 840 N. 87th Streeth, Sargeant Health Center, Milwaukee, WI 53226 | 2013-03-30 |
1407057441 | George Chris Panos | Dentist | N 67 W 31027 Club Circle East, Hartland, WI 53029 | 2007-05-29 |
1053440842 | Oakpark Dental - Platteville | Dentist | 1250 N Water St, Platteville, WI 53818-1450 | 2007-03-05 |
1225191067 | Ezedin M Sadeghi | Dentist | 8760 N Seneca Rd, Fox Point, WI 53217-2332 | 2006-12-19 |
1669558433 | Yeshwant B Rawal | Dentist | 1801 W Wisconsin Ave Rm 322, Milwaukee, WI 53233-2186 | 2006-10-27 |
1225137227 | Guy J Jensen | Dentist | 464 S Hickory St, Suite A, Fond Du Lac, WI 54935-5531 | 2006-09-22 |
1134235427 | Lmg, Inc | Dentist | 2626 N 76th Street, Suite 101, Wauwatosa, WI 53213-1137 | 2006-08-21 |
1730628330 | Lmg Inc | Dentist | 200 W Silver Spring Dr, Suite 310, Milwaukee, WI 53217-5059 | 2017-02-15 |
1891234498 | Lmg Inc | Dentist | 6211 Durand Ave, Suite 202, Mount Pleasant, WI 53406-4956 | 2017-02-15 |
1790224491 | Lmg Inc | Dentist | 2727 N Grandview Blvd, Suite 100, Waukesha, WI 53188-6100 | 2017-02-15 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.