Bright Smiles Dentistry LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BRIGHT SMILES DENTISTRY LLC

Practice address

13500 W Capitol Dr Ste 103
Brookfield, WI 53005-2444

Phone

(262) 563-9100

Fax

(262) 563-9101

NPI assigned

Nov 6, 2021

Organization subpart

No

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

Authorized official

Name

Prasanna Kumari V Muddana

Title

Co Owner/Operations Manager

Phone

(262) 563-9100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1636156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1336804178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 W CAPITOL DR STE 202",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530052444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13500 W CAPITOL DR STE 103",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530052444",
            "telephone_number": "262-563-9100",
            "fax_number": "262-563-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT SMILES DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-06",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "MUDDANA",
        "authorized_official_first_name": "PRASANNA KUMARI",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CO OWNER/OPERATIONS MANAGER",
        "authorized_official_telephone_number": "262-563-9100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Brookfield, WI
• Providers in Brookfield, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.