Waukeshactd1 LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

WAUKESHACTD1 LLC

Practice address

1547 E Racine Ave
Waukesha, WI 53186-6826

Phone

(262) 542-4466

NPI assigned

Jan 28, 2021

Organization subpart

No

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

Authorized official

Name

Mitchell Weiland

Title

Assistant Controller

Phone

(608) 343-0818

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Donald Wade, D.D.S.

  • Dentist
  • Waukesha, WI
  • NPI 1093866238
  NPD (past)

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1356932727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 EXCELSIOR DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171900",
            "telephone_number": "608-343-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1547 E RACINE AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531866826",
            "telephone_number": "262-542-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUKESHACTD1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "WEILAND",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "ASSISTANT CONTROLLER",
        "authorized_official_telephone_number": "608-343-0818"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Waukesha Urology Associates SC
• Waukesha Wellness Way LLC
• Stephanie Renee Weare, CPS
• Amy Weaver, OD
• John R Weaver, PSYD
• Sara Weaver, LCSW, CSAC
• Diane Webb, SAC

• Dentist in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.