Integrative Dental Solutions LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

INTEGRATIVE DENTAL SOLUTIONS LLC

Practice address

N35W23770 Capitol Dr Ste E
Pewaukee, WI 53072-2639

Phone

(262) 691-4555

Fax

(262) 691-4579

NPI assigned

Sep 8, 2015

Last updated

Sep 8, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Supriya Shetty, DDS

Title

Owner

Phone

(262) 691-4555

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441670400000",
    "number": "1316315351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N35W23770 CAPITOL DR STE E",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530722639",
            "telephone_number": "262-691-4555",
            "fax_number": "262-691-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N35W23770 CAPITOL DR STE E",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530722639",
            "telephone_number": "262-691-4555",
            "fax_number": "262-691-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE DENTAL SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-08",
        "last_updated": "2015-09-08",
        "status": "A",
        "authorized_official_last_name": "SHETTY",
        "authorized_official_first_name": "SUPRIYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-691-4555",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• Customized Equipment (DME) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.