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Organization Active NPI

Orthodontic Experts of Wisconsin, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Mount Pleasant, WI
National Provider Identifier
1356053797
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
ORTHODONTIC EXPERTS OF WISCONSIN, LLC
Practice address
1101 S Green Bay Rd
Mount Pleasant, WI 53406-4011
Phone
(262) 421-6614
NPI assigned
Dec 16, 2022
Organization subpart
Yes
Parent organization
ORTHODONTIC EXPERTS OF WISCONSIN, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Authorized official

Name
Monika Bzdal
Title
VP
Phone
(815) 340-1046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

1101 S Green Bay Rd
Mount Pleasant, WI 53406-4011

Mailing address

1700 E Higgins Rd Ste 320
Des Plaines, IL 60018-3805

National Provider Directory

National Provider Directory
Tax ID family
Orthodontic Experts of Wisconsin LLC5 organizations share this tax ID, including this one
Part of
Orthodontic Experts of Wisconsin LLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1101 S Green Bay Rd
Mount Pleasant, WI 53406
Phone (262) 421-6614

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1356053797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E HIGGINS RD STE 320",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600183805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S GREEN BAY RD",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534064011",
            "telephone_number": "262-421-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC EXPERTS OF WISCONSIN, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHODONTIC EXPERTS OF WISCONSIN, LLC",
        "enumeration_date": "2022-12-16",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "BZDAL",
        "authorized_official_first_name": "MONIKA",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "815-340-1046"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.