Active NPI
Brian S. McLellan, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Middleton, WI
National Provider Identifier
1073791521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 6988-15
- Practice address
- 7433 Elmwood Ave
Middleton, WI 53562-3105 - Phone
- (608) 831-7799
- Fax
- (608) 831-8430
- NPI assigned
- Feb 7, 2008
- Last updated
- Nov 8, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 6988-15 | WI | Primary |
Addresses
Primary practice location
7433 Elmwood Ave
Middleton, WI 53562-3105
Mailing address
7433 Elmwood Ave
Middleton, WI 53562-3105
Phone (608) 831-7799
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6988-15 | WI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352332800000",
"number": "1073791521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7433 ELMWOOD AVE",
"city": "MIDDLETON",
"state": "WI",
"postal_code": "535623105",
"telephone_number": "608-831-7799",
"fax_number": "608-831-8430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7433 ELMWOOD AVE",
"city": "MIDDLETON",
"state": "WI",
"postal_code": "535623105",
"telephone_number": "608-831-7799",
"fax_number": "608-831-8430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLELLAN",
"first_name": "BRIAN",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-07",
"last_updated": "2012-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "WI",
"license": "6988-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.