Individual provider Active NPI

Anushree Mehrotra, DDS

  • Student in an Organized Health Care Education/Training Program
  • Milwaukee, WI
National Provider Identifier
1265867006
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1801 W Wisconsin Ave
Graduate Endodontics,Marquette Dental School
Milwaukee, WI 53233-2186
Phone
(414) 288-7047
NPI assigned
Sep 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1801 W Wisconsin Ave
Graduate Endodontics,Marquette Dental School
Milwaukee, WI 53233-2186

Mailing address

1801 W Wisconsin Ave
Graduate Endodontics, Maquette Dental School
Milwaukee, WI 53233-2186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160105001792 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0840592044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7178WIMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1265867006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W WISCONSIN AVE",
            "address_2": "GRADUATE ENDODONTICS, MAQUETTE DENTAL SCHOOL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W WISCONSIN AVE",
            "address_2": "GRADUATE ENDODONTICS,MARQUETTE DENTAL SCHOOL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332186",
            "telephone_number": "414-288-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHROTRA",
        "first_name": "ANUSHREE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.