TIMBERCREST DENTAL CENTER, S.C. (NPI# 1356414114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356414114 |
| Entity Type | Organization |
| Organization Name | TIMBERCREST DENTAL CENTER, S.C. |
| Practice Address |
821 E 1st Ave Suite 3 Appleton WI 54911-1501 |
| Practice Telephone | 9207349148 |
| Practice Fax Number | 9207348710 |
| Mailing Telephone | 9207349148 |
| Mailing Fax Number | 9207348710 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOHN BERTON LUTHER (PRESIDENT) |
| Authorized Official Telephone | 9207349148 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
5588-015 | WI | Ambulatory Health Care Facilities |
| Street Address |
821 E 1ST AVE SUITE 3 |
| City | APPLETON |
| State | WI |
| Zip Code | 54911-1501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134130164 | Health Matters Muscular Therapy Clinic, LLC | Massage Therapist | 821 E 1st Ave, Suite #4, Appleton, WI 54911-1501 | 2006-08-11 |
| 1760758023 | Ceres Group LLC | Occupational Therapist | 821 E 1st Ave, Suite 3, Appleton, WI 54911-1500 | 2012-03-30 |
| 1992082259 | Theresa M. Petrenchik | Occupational Therapist | 821 E 1st Ave, Suite 5, Appleton, WI 54911-1586 | 2011-11-14 |
| 1285923870 | Michelle Wisneski | Counselor | 821 E 1st Ave, Suite 5, Appleton, WI 54911-1586 | 2011-04-04 |
| 1720217482 | Jane Elizabeth Wisneski | Counselor | 821 E 1st Ave, Suite 5, Appleton, WI 54911-1586 | 2009-07-02 |
| 1548489610 | Douglas Alan Krueger | Dentist | 821 E 1st Ave, Suite 1, Appleton, WI 54911-1501 | 2007-04-25 |
| 1457424210 | John Berton Luther | Dentist | 821 E 1st Ave, Suite 3, Appleton, WI 54911-1501 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912545633 | Brotherly Love, LLC | Day Training, Developmentally Disabled Services | 1513 E Frances St, Appleton, WI 54911 | 2019-12-12 |
| 1952952129 | Eagle Point Senior Living Inc | Assisted Living Facility | 995 East John Street, Appleton, WI 54911 | 2019-09-27 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1174080063 | Shayla Russell | Counselor | Outagamie County Health and Human Services, 320 S. Walnut St., Appleton, WI 54911 | 2019-02-27 |
| 1871086645 | Megan Kilsdonk | Health Educator | 1604 N Meade St, Appleton, WI 54911 | 2018-06-07 |
| 1871085480 | Tanya Lynn Vickery | Social Worker | 410 S. Elm St., Appleton, WI 54911 | 2018-05-31 |
| 1013407501 | Teri G Metropulos | Counselor | 229 S. Morrison, Appleton, WI 54911 | 2018-05-10 |
| 1093211211 | Bonnie Anne Korytkowski | Student in an Organized Health Care Education/Training Program | 229 S. Morrison Street, Appleton, WI 54911 | 2018-04-05 |
| 1639673940 | Brett Follett | Psychologist | 401 S. Elm St., Appleton, WI 54911 | 2018-03-21 |
| 1700202892 | Brian Withrow | Counselor | 607 West 7th St., Appleton, WI 54911 | 2014-03-13 |
| Find all providers in zip 54911 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336237551 | Tri-county Community Dental Clinic, Inc. | Clinic/Center | 9 Tri Park Way, Appleton, WI 54914-1661 | 2006-10-11 |
| 1194241216 | North Appleton Dentistry, LLC | Clinic/Center | 3521 Commerce Ct, Appleton, WI 54911-8579 | 2017-08-21 |
| 1124540315 | Fox Run Dental, LLC | Clinic/Center | 229 E Franklin St, Appleton, WI 54911-5434 | 2017-07-10 |
| 1811430796 | First Impressions Sc | Clinic/Center | 4182 W Wisconsin Ave, Appleton, WI 54913-8652 | 2016-11-28 |
| 1497115232 | Appleton Dental Care, P.a. | Clinic/Center | 32 S Behl St, Appleton, MN 56208-1616 | 2016-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063907 | Osceola Family Dental, Ltd | Clinic/Center | 215 N Cascade St, Osceola, WI 54020 | 2020-11-03 |
| 1578173985 | Bright Dental and Braces LLC | Clinic/Center | 3046 Fish Hatchery Rd, Fitchburg, WI 53713-3125 | 2020-08-01 |
| 1609493188 | Willow Dental Group LLC | Clinic/Center | 3333 S Sunnyslope Rd Ste 100, New Berlin, WI 53151-4504 | 2020-06-30 |
| 1447875711 | Iola Family Dental, LLC | Clinic/Center | 100 Pine Crest Ln, Iola, WI 54945-8230 | 2020-06-12 |
| 1073135331 | Oasis Dental LLC | Clinic/Center | 1037 S Cesar E Chavez Dr, Milwaukee, WI 53204-2204 | 2020-05-09 |
| 1679116685 | Mdc Milwaukee, LLC | Clinic/Center | 4701 W National Ave, Milwaukee, WI 53214-3521 | 2019-10-22 |
| 1982263893 | Schmidt Dental Holdings LLC | Clinic/Center | 7430 W Forest Home Ave, Greenfield, WI 53220-3358 | 2019-06-13 |
| 1124580352 | Upper Lakes Dental, LLC | Clinic/Center | 908 E Main St Ste C, Winneconne, WI 54986-9672 | 2019-04-05 |
| 1356808067 | Julia Fosterarmstrong | Clinic/Center | 335 Vernal Ave, Milton, WI 53563-1248 | 2019-02-28 |
| 1366907032 | Dr John M Kane Sc | Clinic/Center | 10317 N Greenwood Ln, Hayward, WI 54843-7167 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
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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.