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1962532325 NPI number — WISCONSIN DENTAL GROUP, S.C.

NPI Number: 1962532325
Health Care Provider/Practitioner: WISCONSIN DENTAL GROUP, S.C.

Information about “1962532325” NPI (WISCONSIN DENTAL GROUP, S.C.) exists in 1962532325 in HTML format HTML  |  1962532325 in plain Text format TXT  |  1962532325 in PDF (Portable Document Format) PDF  |  1962532325 in an XML format XML  formats.

NPI Number : 1962532325 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962532325",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "WISCONSIN DENTAL GROUP, S.C.",
    "ParentOrgTIN": null,
    "OrgName": "WISCONSIN DENTAL GROUP, S.C.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2 SCIENCE CT STE 100",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MADISON",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53711-1090",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "262-542-8860",
    "MailingAddressFaxNumber": "262-524-9225",
    "FirstLinePracticeLocationAddress": "2 SCIENCE CT STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MADISON",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53711-1090",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "262-542-8860",
    "PracticeLocationAddressFaxNumber": "262-524-9225",
    "EnumerationDate": "03/06/2007",
    "LastUpdateDate": "04/15/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HAYES",
    "AuthorizedOfficialFirstName": "CELIA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CREDENTIALING COORDINATOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "217-540-2100",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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