Sweet Tooth Pediatric Dentistry, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SWEET TOOTH PEDIATRIC DENTISTRY, LLC

Practice address

311 Financial Way Ste 200
Wausau, WI 54401-4288

Phone

(715) 214-1234

Fax

(714) 214-1235

NPI assigned

Jan 17, 2023

Last updated

Jan 17, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Brittany Zamudio

Title

Office Manager

Phone

(360) 991-6098

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1225743941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118600 SUNSET RIDGE DR",
            "city": "STRATFORD",
            "state": "WI",
            "postal_code": "544844428",
            "telephone_number": "715-214-1234",
            "fax_number": "715-214-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 FINANCIAL WAY STE 200",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014288",
            "telephone_number": "715-214-1234",
            "fax_number": "714-214-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEET TOOTH PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "ZAMUDIO",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-991-6098",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lauren Susa, OTR
• Susan Stacker DDS SC
• Amy L Sutheimer, DPT
• James P Sutherland Jr., MD
• Lois Swanson, LCSW
• Gary Theodore Sweet Jr., MD
• Alyson Sweno, RN
• Tony Swicer Jr., DO
• Sara Ellen Switek, LCSW
• Van W Sykes, DMD

• Pediatric Dentistry in Wausau, WI
• Providers in Wausau, WI by specialty
• Pediatric Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.