NPIMap

Quirt Family Dentistry, SC

Organization Active NPI General Practice Dentistry · Grafton, WI

NPI 1124569181 · NPPES record last updated Mar 10, 2017

Key facts

NPI
1124569181
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
QUIRT FAMILY DENTISTRY, SC
Practice address
1580 Port Washington Road
Grafton, WI 53024
Phone
(262) 671-1969
NPI assigned
Mar 10, 2017
Organization subpart
Yes
Parent organization (as reported)
QUIRT FAMILY DENTISTRY, SC

Authorized official

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

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.

Corporate family (same tax ID) 31

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

View all 31

National Provider Directory

Tax ID family
Quirt Family Dentistry SC (32 organizations share this tax ID)
Part of
Quirt Family Dentistry SC

Locations

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP		 1223G0001X Yes

Addresses

Primary practice location

1580 Port Washington Road
Grafton, WI 53024

Mailing address

1580 Port Washington Road
Grafton, WI 53024

Other names

  • Dental Care of Grafton Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 10, 2017.

{
    "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

All providers in Grafton, WI · General Practice Dentistry in Wisconsin

Sources for this page

Verify at the official NPI Registry.