NPIMap

Organization Active NPI

Phillips Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Madison, WI
National Provider Identifier
1104999796
Registry record updated Dec 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
4603 Issued in WI
Legal business name
PHILLIPS ORTHODONTICS
Practice address
5605 Odana Rd
Madison, WI 53719-1207
Phone
(608) 271-9293
Fax
(608) 204-9216
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2014

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

Authorized official

Name
Dr. Jeffrey Joseph Phillips, D.D.S, M.S.NPI 1518030196
Title
Orthodontist
Phone
(608) 271-9293

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
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 4603 WI Primary

Addresses

Primary practice location

5605 Odana Rd
Madison, WI 53719-1207

Mailing address

5605 Odana Rd
Madison, WI 53719-1207
Phone (608) 271-9293

Other identifiers 1

IdentifierTypeStateIssuer
33722200MedicaidWI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417737600000",
    "number": "1104999796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 ODANA RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191207",
            "telephone_number": "608-271-9293",
            "fax_number": "608-204-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 ODANA RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191207",
            "telephone_number": "608-271-9293",
            "fax_number": "608-204-9216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2014-12-05",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "608-271-9293",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S, M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "4603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33722200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; 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.