NPIMap

Organization Active NPI

D2 Dental of Wisconsin, S.C.

  • General Practice Dentistry
  • Milwaukee, WI
National Provider Identifier
1245742733
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
D2 DENTAL OF WISCONSIN, S.C.
Practice address
1838 S 15TH St
Milwaukee, WI 53204-3225
Phone
(414) 455-8805
NPI assigned
Oct 25, 2017
Last updated
Nov 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Authorized official

Name
Boris Labinov
Title
Agent
Phone
(708) 613-4542

Specialties & licenses 1

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

Addresses

Primary practice location

1838 S 15TH St
Milwaukee, WI 53204-3225

Mailing address

137 N Oak Park Ave Ste 310
Oak Park, IL 60301-1339

National Provider Directory

National Provider Directory
Tax ID family
D2 Dental of Wisconsin SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604966400000",
    "number": "1245742733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 N OAK PARK AVE STE 310",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1838 S 15TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532043225",
            "telephone_number": "414-455-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D2 DENTAL OF WISCONSIN, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-25",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "LABINOV",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "708-613-4542"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.