NPIMap

Organization Active NPI

American Dental Specialty Institute, SC

  • Periodontics
  • West Allis, WI
National Provider Identifier
1295930634
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
3218 Issued in WI
Legal business name
AMERICAN DENTAL SPECIALTY INSTITUTE, SC
Practice address
2323 S 109TH St
Suite 275
West Allis, WI 53227-1909
Phone
(414) 321-7200
Fax
(414) 321-3232
NPI assigned
Jun 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ahmad Eslami, D.M.D., M.S.NPI 1801907886
Title
President
Phone
(414) 321-7200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 3218 WI Primary

Addresses

Primary practice location

2323 S 109TH St
Suite 275
West Allis, WI 53227-1909

Mailing address

2323 S 109TH St
Suite 275
West Allis, WI 53227-1909
Phone (414) 321-7200

Other names 1

  • Dental Implant Institute of Wisconsin Other name

National Provider Directory

National Provider Directory

Locations

2323 S 109th St
Ste 275
West Allis, WI 53227
Phone (414) 321-7200

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295930634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 S 109TH ST",
            "address_2": "SUITE 275",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271909",
            "telephone_number": "414-321-7200",
            "fax_number": "414-321-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 S 109TH ST",
            "address_2": "SUITE 275",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271909",
            "telephone_number": "414-321-7200",
            "fax_number": "414-321-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN DENTAL SPECIALTY INSTITUTE, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ESLAMI",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-321-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "WI",
            "license": "3218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Implant Institute of Wisconsin",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.