Southport Periodontics

ActiveOrganizationDentistry
NPI issued: May 22, 2018

Quick Facts

NPI Number
1679064901
TypeOrganization
StatusActive
SpecialtyDentistry
Taxonomy1223P0300X — Dentistry
Phone
(262) 654-6770
StateWI

NPI Validation Status: Verified

✅Valid 10-digit NPI number (1679064901)
✅Active status confirmed
✅Verified by CMS NPPES Registry
✅HIPAA compliant identifier
✅Enumeration date on file (May 22, 2018)
Data source: CMS NPPES

Provider Overview

SOUTHPORT PERIODONTICS is a Dentistry provider based in Kenosha, WI who has been registered with CMS since 2018. This NPI is currently Active under CMS NPPES registry.

Provider Details

NPI Number1679064901
Provider TypeOrganization
StatusActive
Enumeration DateMay 22, 2018

Practice Location

CityKenosha
StateWI
ZIP Code53144
Phone(262) 654-6770

Specialties & Licenses

★ Primary
SpecialtyDentistry
Taxonomy Code1223P0300X
License StateWI

Mailing Address

CityKenosha
StateWI
ZIP Code53144
Phone(262) 654-6770
Same as practice location

How to Use This NPI

📋

For Insurance Billing

Use NPI 1679064901 in Box 33 of the CMS-1500 claim form. This number is required by all major insurance carriers to identify the billing provider and process electronic medical claims.

🏥

For Credentialing

Reference NPI 1679064901for provider credential verification. Hospital systems, state licensing boards, and CAQH directories query this number to verify the provider's active clinical status.

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For Patients

Share NPI 1679064901 with your insurance company. If you need to verify out-of-network benefits or file a reimbursement claim, your insurance provider will require this number to process it.

About Dentistry

Specialists in Dentistry provide expert clinical care within their specific domain, focusing on the diagnosis, treatment, and management of conditions relevant to their field of practice.

Browse all Dentistryproviders →
📊
8,369
Dentistry Providers in the US

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People Also Ask

What is Southport Periodontics's NPI number?
Southport Periodontics's NPI number is 1679064901, a unique 10-digit identifier issued by the Centers for Medicare & Medicaid Services (CMS).
Is Southport Periodontics's NPI currently active?
Yes, Southport Periodontics's NPI status is Active as of the latest CMS NPPES database updates.
What does Southport Periodontics specialize in?
Southport Periodontics specializes in Dentistry. The healthcare taxonomy code associated with this specialty is 1223P0300X.
Where does Southport Periodontics practice?
Southport Periodontics practices in Kenosha, WI 53144.
When was Southport Periodontics's NPI issued?
Southport Periodontics's NPI was issued on May 22, 2018.
What is Southport Periodontics's provider type?
Southport Periodontics is registered as an Organization under CMS NPI Type 2.