Organization Active NPI

Belle City Family Dentistry, S.C.

  • Dentist
  • Racine, WI
National Provider Identifier
1023565686
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7238-15 Issued in WI
Legal business name
BELLE CITY FAMILY DENTISTRY, S.C.
Practice address
1300 S Green Bay Rd
Suite 206
Racine, WI 53406
Phone
(262) 633-4000
NPI assigned
Sep 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kimberly Olesen, D.D.S.
Title
President
Phone
(262) 497-5374

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 7238-15 WI Primary
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X 5001949-015 WI

Addresses

Primary practice location

1300 S Green Bay Rd
Suite 206
Racine, WI 53406

Mailing address

1300 S Green Bay Rd
Suite 206
Racine, WI 53406
Phone (262) 633-4000

National Provider Directory

National Provider Directory

Locations

1300 S Green Bay Rd
Ste 206
Mount Pleasant, WI 53406
Phone (262) 633-4000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1023565686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S GREEN BAY RD",
            "address_2": "SUITE 206",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "53406",
            "telephone_number": "262-633-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S GREEN BAY RD",
            "address_2": "SUITE 206",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "53406",
            "telephone_number": "262-633-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLE CITY FAMILY DENTISTRY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "OLESEN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-497-5374",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "7238-15",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "WI",
            "license": "5001949-015",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.