VALLEY PERIODONTICS, S.C. (NPI# 1821156241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821156241 |
| Entity Type | Organization |
| Organization Name | VALLEY PERIODONTICS, S.C. |
| Practice Address |
2535 Norther Road Appleton WI 54914 |
| Practice Telephone | 9207313224 |
| Practice Fax Number | 9207312910 |
| Mailing Telephone | 9207313224 |
| Mailing Fax Number | 9207312910 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. S. TIMOTHY ROSE (PRESIDENT) |
| Authorized Official Telephone | 9207313224 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
| Street Address |
2535 NORTHER ROAD |
| City | APPLETON |
| State | WI |
| Zip Code | 54914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572429 | Claire Schuh | Social Worker | 3416 Association Ln, Appleton, WI 54914 | 2020-09-09 |
| 1568099729 | Access Elevator, Inc. | Contractor | 1314 W. College Ave, Appleton, WI 54914 | 2020-03-26 |
| 1124677885 | Sharon Darla Cornell | Technician | 3117 N. Mistwood Lane, Appleton, WI 54914 | 2019-09-05 |
| 1235647793 | Midwest Monitoring, LLC | Psychiatry & Neurology | 4321 W College Ave Ste 200, Appleton, WI 54914 | 2018-01-18 |
| 1356863252 | Uvanta Pharmacy LLC | Pharmacy | 1050 S Grider St, Suite C, Appleton, WI 54914 | 2017-07-12 |
| 1255860912 | Appleton Counseling Management LLC | Counselor | 477 S Nicolet Rd., Appleton, WI 54914 | 2017-06-07 |
| 1609269489 | Shane Scott Urban | Social Worker | 444 N. Westhill Blvd., Appleton, WI 54914 | 2015-03-18 |
| 1699184580 | Michelle Becker | Nurse Practitioner | 4435 West Lawrence St., Appleton, WI 54914 | 2014-08-05 |
| 1972857514 | Jean Flesch | Pharmacist | 1000 W. Northland Ave., Appleton, WI 54914 | 2012-11-05 |
| 1477845147 | Mallory Barbara Herrin | Counselor | 820 W. College Ave, Appleton, WI 54914 | 2011-05-12 |
| Find all providers in zip 54914 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558662387 | Jason William Cooke | Dentist | 2557b E Calumet St, Appleton, WI 54915-4748 | 2010-11-10 |
| 1134339500 | Fox River Periodontics Sc | Dentist | 2557b East Calumet St, Appleton, WI 54915 | 2007-05-23 |
| 1952422073 | George M Jumes | Dentist | 2535 Northern Rd, Appleton, WI 54914-8753 | 2007-04-03 |
| 1174644298 | Todd L Needham | Dentist | 2535 Northern Rd, Appleton, WI 54914-8753 | 2007-04-03 |
| 1225159338 | S Timothy Rose | Dentist | 2535 Northern Rd, Appleton, WI 54914-8753 | 2007-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235683830 | Phillip Crum | Dentist | 2581 Development Dr Ste 204, Bellevue, WI 54311-4248 | 2016-08-11 |
| 1285937557 | Craig William Byers | Dentist | 2457 North Mayfair Road, Suite 102, Wauwatosa, WI 53226-1405 | 2010-12-08 |
| 1780998997 | Thomas C. Kelley Dds Msd LLC | Dentist | 17280 W North Ave Ste 203, Brookfield, WI 53045-4366 | 2010-07-29 |
| 1376789933 | Shoreline Periodontics Limited | Dentist | 2808 Kohler Memorial Dr, Suite 2, Sheboygan, WI 53081-3177 | 2008-12-31 |
| 1003052895 | James P. Herman | Dentist | 5624 S Bonnie Ln, Hales Corners, WI 53130-1674 | 2008-12-28 |
| 1760684930 | Jeffrey Joseph Burke | Dentist | 2323 S 109th St Ste 275, West Allis, WI 53227-1912 | 2007-06-01 |
| 1992915276 | Scott George Metskas | Dentist | 3364 Iris Ln, Stevens Point, WI 54481-5618 | 2007-05-23 |
| 1891903043 | Denise Y Shih | Dentist | 2853 N Marietta Ave, Milwaukee, WI 53211-3420 | 2007-05-20 |
| 1629280987 | Nancy Ellen Shumate | Dentist | 2600 N Mayfair Rd Ste 340, Wauwatosa, WI 53226-1372 | 2007-05-07 |
| 1669684726 | St Croix Periodontics | Dentist | 1200 Crestview Drive, Suite4, Hudson, WI 54016-9391 | 2007-05-03 |
| 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.