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Active NPI 1497481063 Individual Practitioner Male Practitioner

Dr. Ian Alexander Niccum , DMD

Dentist - General Practice • Appleton, WI

Professional Overview & Biography Verified Profile Summary

Dr. Ian Niccum, DMD is a registered healthcare professional specializing in Dentist - General Practice in Appleton, WI. Practice services are available at W6261 NEUBERT RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

W6261 Neubert Rd

Appleton, WI 54913

Telephone 9209541110

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Appleton, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 24.5 Yrs
Regional Practice Density
86 Specialists

Practicing in Appleton, WI (2459 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-04-07
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License WI 6000061-15

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Secondary Practice Locations

N1734 Lily Of The Valley Dr

Greenville, WI 549429044

Phone: 9202892440

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1043053986

Doctor of Dental Surgery

NPI 1285831545

Doctor of Dental Surgery

NPI 1356276554

Doctor of Dental Surgery

Dr. Trenton Paffenroth , DMD

Dentist - General Practice

NPI 1619386208

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location April 14, 2025

Registered at W6261 NEUBERT RD, APPLETON, WI 54913 (Tel: 9209541110)

📍
Updated Business Mailing Address April 14, 2025

Registered at W7030 BLUEBLUFF WAY, GREENVILLE, WI 549429783 (Tel: 2177221737)

NPI Profile Active July 26, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location July 26, 2022

Registered at N1734 LILY OF THE VALLEY DR, GREENVILLE, WI 549429044 (Tel: 9202892440)

📍
Updated Business Mailing Address July 26, 2022

Registered at 1843 PALISADES DR, APPLETON, WI 549151026 (Tel: 2177221737)

👤
Provider Name / Credentials Updated July 26, 2022

Recorded as IAN NICCUM, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 26, 2022

Dentist (License #6000061-15 in WI)

🟢
Initial NPI Registration & Enumeration July 26, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497481063
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 26, 2022
Last Update: April 14, 2025
Sole Proprietor: No

Mailing Address

W7030 Bluebluff Way

Greenville, WI 549429783

Phone: 2177221737

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.