ORAL & MAXILLOFACIAL SURGERY FOX CITIES S.C. (NPI# 1861525289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861525289 |
| Entity Type | Organization |
| Organization Name | ORAL & MAXILLOFACIAL SURGERY FOX CITIES S.C. |
| Practice Address |
5395 Michaels Dr Appleton WI 54913-8447 |
| Practice Telephone | 9207391214 |
| Practice Fax Number | 9207395855 |
| Mailing Telephone | 9207391214 |
| Mailing Fax Number | 9207395855 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. ANN K DUDLEY (OFFICE MANAGER) |
| Authorized Official Telephone | 9207391214 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
WI | Ambulatory Health Care Facilities |
| Street Address |
5395 MICHAELS DR |
| City | APPLETON |
| State | WI |
| Zip Code | 54913-8447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265490437 | Timothy Ivan Zuck | Specialist | 5395 Michaels Dr, Appleton, WI 54913-8447 | 2006-05-03 |
| 1154555373 | Oral & Maxillofacial Surgery Fox Cities, S.c. | Durable Medical Equipment & Medical Supplies | 5395 Michaels Dr, Appleton, WI 54913-8447 | 2009-05-04 |
| 1992895031 | John J. Rydlewicz | Dentist | 5395 Michaels Dr, Appleton, WI 54913-8447 | 2006-10-12 |
| 1982652855 | Jefferey L Casperson | Specialist | 5395 Michaels Dr, Appleton, WI 54913-8447 | 2006-05-04 |
| 1417905381 | Christopher Bergstrom | Specialist | 5395 Michaels Dr, Appleton, WI 54913-8447 | 2006-05-04 |
| 1962460253 | Arthur Clarence Helgerson | Specialist | 5395 Michaels Dr, Appleton, WI 54913-8447 | 2006-05-03 |
| 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 | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053972661 | Oconomowoc Dental Anesthesia Center | Clinic/Center | 888 Thackeray Trl Ste 214, Oconomowoc, WI 53066-4342 | 2019-06-25 |
| 1962531178 | Oral Surgery Clinic of La Crosse Ltd. | Clinic/Center | 2819 National Dr, Onalaska, WI 54650-6703 | 2007-03-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
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