NPIMap

Organization Active NPI

Waukesha County Community Dental Clinic, Inc.

  • Dental Clinic/Center
  • Menomonee Falls, WI
National Provider Identifier
1053814772
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
WAUKESHA COUNTY COMMUNITY DENTAL CLINIC, INC.
Practice address
N81W15062 Appleton Ave
Menomonee Falls, WI 53051
Phone
(262) 953-4699
Fax
(262) 522-2828
NPI assigned
Mar 9, 2018
Last updated
Aug 10, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
WAUKESHA COUNTY COMMUNITY DENTAL CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2018

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

Authorized official

Name
Renee Ramirez
Title
Executive Director
Phone
(262) 953-4699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X WI Primary

Addresses

Primary practice location

N81W15062 Appleton Ave
Menomonee Falls, WI 53051

Mailing address

210 NW Barstow St Ste 305
Waukesha, WI 53188-3771
Phone (262) 953-4699

Other practice location 1

210 NW Barstow St Ste 305
Waukesha, WI 53188-3771
Phone (262) 953-4699

Other identifiers 1

IdentifierTypeStateIssuer
38398500MedicaidWI

Other names 2

  • Waukesha County Community Dental Clinic Other name
  • Waukesha County Community Dental Clinic - Menomonee Falls Other name

National Provider Directory

National Provider Directory
Tax ID family
Waukesha County Community Dental Clinic Inc2 organizations share this tax ID, including this one
Part of
Waukesha County Community Dental Clinic Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

N81W15062 Appleton Ave
Menomonee Falls, WI 53051
Phone (262) 522-7645

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533859200000",
    "number": "1053814772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 NW BARSTOW ST STE 305",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883771",
            "telephone_number": "262-953-4699",
            "fax_number": "262-522-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N81W15062 APPLETON AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "53051",
            "telephone_number": "262-953-4699",
            "fax_number": "262-522-2828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 NW Barstow St Ste 305",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531883771",
            "country_code": "US",
            "telephone_number": "262-953-4699",
            "fax_number": "262-522-2828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WAUKESHA COUNTY COMMUNITY DENTAL CLINIC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAUKESHA COUNTY COMMUNITY DENTAL CLINIC",
        "enumeration_date": "2018-03-09",
        "last_updated": "2018-08-10",
        "status": "A",
        "authorized_official_last_name": "RAMIREZ",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "262-953-4699"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38398500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waukesha County Community Dental Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Waukesha County Community Dental Clinic - Menomonee Falls",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Menomonee Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; 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.