NPIMap

Organization Active NPI

Andrea M Bertotto, D.D.S., S.C.

  • Dentist
  • Wisconsin Rapids, WI
National Provider Identifier
1194135582
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6047-015 Issued in WI
Legal business name
ANDREA M BERTOTTO, D.D.S., S.C.
Practice address
1980 7TH St S
Wisconsin Rapids, WI 54494-6017
Phone
(715) 423-7160
Fax
(715) 424-7337
NPI assigned
May 6, 2014
Last updated
May 6, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Authorized official

Name
Dr. Andrea M Bertotto, D.D.S.NPI 1962684233
Title
President
Phone
(715) 423-7160

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6047-015 WI Primary

Addresses

Primary practice location

1980 7TH St S
Wisconsin Rapids, WI 54494-6017

Mailing address

1980 7TH St S
Wisconsin Rapids, WI 54494-6017
Phone (715) 423-7160

National Provider Directory

National Provider Directory

Locations

1980 7th St S
Wisconsin Rapids, WI 54494
Phone (715) 423-7160

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1194135582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 7TH ST S",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544946017",
            "telephone_number": "715-423-7160",
            "fax_number": "715-424-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 7TH ST S",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544946017",
            "telephone_number": "715-423-7160",
            "fax_number": "715-424-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREA M BERTOTTO, D.D.S., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-06",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "BERTOTTO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-423-7160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "6047-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.