NPIMap

Organization Active NPI

Munoz Family and Cosmetic Dentistry

  • Dental Clinic/Center
  • Green Bay, WI
National Provider Identifier
1073101507
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MUNOZ FAMILY AND COSMETIC DENTISTRY
Practice address
410 Security Blvd
Green Bay, WI 54313-9705
Phone
(920) 662-1440
NPI assigned
Jan 10, 2021
Last updated
Jul 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Dr. Juan Munoz, DDSNPI 1114453024
Title
Owner/ Doctor
Phone
(920) 662-1440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

410 Security Blvd
Green Bay, WI 54313-9705

Mailing address

410 Security Blvd
Green Bay, WI 54313-9705
Phone (920) 662-1440

Other names 1

  • Center for Dental Excellence Former legal business name

National Provider Directory

National Provider Directory

Locations

410 Security Blvd
Green Bay, WI 54313
Phone (920) 662-1440

Practitioners & affiliated clinicians

Practitioners 3

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": "1610236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1073101507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 SECURITY BLVD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543139705",
            "telephone_number": "920-662-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 SECURITY BLVD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543139705",
            "telephone_number": "920-662-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNOZ FAMILY AND COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-10",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_title_or_position": "OWNER/ DOCTOR",
        "authorized_official_telephone_number": "920-662-1440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Dental Excellence",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Center for Dental Excellence",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.