Northtown Dental Group S.C.

Primary specialty

DentistTaxonomy code 122300000X

License

5001475 Issued in WI

Legal business name

NORTHTOWN DENTAL GROUP S.C.

Practice address

1929 W Atkinson Ave
Milwaukee, WI 53206-2452

Phone

(414) 442-4690

NPI assigned

Sep 2, 2009

Organization subpart

No

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

Authorized official

Name

Dr. James W Mack

Title

President

Phone

(414) 442-4690

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1386877702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 W ATKINSON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532062452",
            "telephone_number": "414-442-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1929 W ATKINSON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532062452",
            "telephone_number": "414-442-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHTOWN DENTAL GROUP S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-02",
        "last_updated": "2009-09-02",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-442-4690",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "5001475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333981000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northern Crossing Behavioral Health Services, LLC
• Northern Home Care Group SC
• Northern Medical Equipment & Supplies LLC
• Northridge Dental Center S.C.
• Northside Family Resources LLC
• Sara Northway, M.D.
• Northwest Surgery Center Inc
• Anita Marie Norton, CPNP-PC
• Casey Josiah Norton
• April K Norwood

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; 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.