NPIMap

Organization Active NPI

Quad/Med, LLC

  • Dental Clinic/Center
  • West Allis, WI
National Provider Identifier
1174089130
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
QUAD/MED, LLC
Practice address
555 S 108TH St
West Allis, WI 53214-1145
Phone
(414) 566-3725
Fax
(414) 566-3900
NPI assigned
Feb 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Authorized official

Name
Robert L Poulsen
Title
Cfo
Phone
(414) 566-8400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

555 S 108TH St
West Allis, WI 53214-1145

Mailing address

W227N6103 Sussex Rd
Sussex, WI 53089-3969
Phone (414) 566-8400

Other names 1

  • Quad Med Dental West Allis Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Quad Med Managment LLC56 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

W227N6103 Sussex Rd
Sussex, WI 53089
Phone (414) 566-6400

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1174089130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W227N6103 SUSSEX RD",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530893969",
            "telephone_number": "414-566-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S 108TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532141145",
            "telephone_number": "414-566-3725",
            "fax_number": "414-566-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAD/MED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "POULSEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "414-566-8400"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quad Med Dental West Allis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.