NPIMap

Organization Active NPI

Quirt Family Dentistry, SC

Doing business as Dental Care of Grafton

  • General Practice Dentistry
  • Grafton, WI
National Provider Identifier
1124569181
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
QUIRT FAMILY DENTISTRY, SC
Doing business as
Dental Care of Grafton
Practice address
1580 Port Washington Road
Grafton, WI 53024
Phone
(262) 671-1969
NPI assigned
Mar 10, 2017
Last updated
Mar 10, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
QUIRT FAMILY DENTISTRY, SCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Authorized official

Name
Kendra Walker
Title
Credentialing Supervisor
Phone
(217) 540-8312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1580 Port Washington Road
Grafton, WI 53024

Mailing address

1580 Port Washington Road
Grafton, WI 53024

Other names 1

  • Dental Care of Grafton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Quirt Family Dentistry32 organizations share this tax ID, including this one
Part of
Quirt Family Dentistry

Other organizations with this tax ID 31

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

View all 31

Locations

1580 Port Washington Rd
Grafton, WI 53024
Phone (262) 618-4204

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.

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1124569181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 PORT WASHINGTON ROAD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "53024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 PORT WASHINGTON ROAD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "53024",
            "telephone_number": "262-671-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUIRT FAMILY DENTISTRY, SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUIRT FAMILY DENTISTRY, SC",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "217-540-8312"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care of Grafton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grafton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.