NPIMap

Organization Active NPI

Orthodontic Experts of Wisconsin, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Beloit, WI
National Provider Identifier
1245834084
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
ORTHODONTIC EXPERTS OF WISCONSIN, LLC
Practice address
2692 Cranston Rd
Beloit, WI 53511-6908
Phone
(855) 720-2470
NPI assigned
Nov 23, 2020
Last updated
Nov 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

Name
Monika Bzdal
Title
Director of Support Services
Phone
(773) 801-7171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU Primary

Addresses

Primary practice location

2692 Cranston Rd
Beloit, WI 53511-6908

Mailing address

1250 W Northwest Hwy
Mount Prospect, IL 60056-2274

National Provider Directory

National Provider Directory
Tax ID family
Orthodontic Experts of Wisconsin LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

2692 Cranston Rd
Beloit, WI 53511
Phone (855) 720-2470

Ownership & related parties

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1245834084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W NORTHWEST HWY",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600562274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2692 CRANSTON RD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535116908",
            "telephone_number": "855-720-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC EXPERTS OF WISCONSIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "BZDAL",
        "authorized_official_first_name": "MONIKA",
        "authorized_official_title_or_position": "DIRECTOR OF SUPPORT SERVICES",
        "authorized_official_telephone_number": "773-801-7171"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.