Individual provider Active NPI

Andrew Teduits, DDS

  • Pediatric Dentistry
  • Fitchburg, WI
National Provider Identifier
1255969499
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
1002737 Issued in WI
Practice address
5544 E Cheryl Pkwy
Fitchburg, WI 53711-5312
Phone
(608) 288-1543
NPI assigned
Apr 1, 2020
Last updated
Dec 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 1002737 WI Primary

Addresses

Primary practice location

5544 E Cheryl Pkwy
Fitchburg, WI 53711-5312

Mailing address

5544 E Cheryl Pkwy
Fitchburg, WI 53711-5312
Phone (608) 288-1543

Other practice location 1

250 N City Station Dr
Sun Prairie, WI 53590-4718
Phone (608) 453-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1002737WIMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1255969499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5544 E CHERYL PKWY",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115312",
            "telephone_number": "608-288-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5544 E CHERYL PKWY",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115312",
            "telephone_number": "608-288-1543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 N City Station Dr",
            "address_purpose": "LOCATION",
            "city": "Sun Prairie",
            "state": "WI",
            "postal_code": "535904718",
            "country_code": "US",
            "telephone_number": "608-453-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEDUITS",
        "first_name": "ANDREW",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "1002737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.