NPIMap

Organization Active NPI

Delafield Dental Specialists LLC

  • General Practice Dentistry
  • Delafield, WI
National Provider Identifier
1407208002
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6886 Issued in WI
Legal business name
DELAFIELD DENTAL SPECIALISTS LLC
Practice address
920 Indian Spring Dr
Delafield, WI 53018-2242
Phone
(262) 646-2771
Fax
(262) 646-2340
NPI assigned
Jul 7, 2016
Last updated
Jul 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Authorized official

Name
Mr. Christopher Potrykus, DDSNPI 1033477765
Title
Owner
Phone
(262) 646-2771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6886 WI Primary

Addresses

Primary practice location

920 Indian Spring Dr
Delafield, WI 53018-2242

Mailing address

920 Indian Spring Dr
Delafield, WI 53018-2242
Phone (262) 646-2771

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467849600000",
    "number": "1407208002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 INDIAN SPRING DR",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530182242",
            "telephone_number": "262-646-2771",
            "fax_number": "262-646-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 INDIAN SPRING DR",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530182242",
            "telephone_number": "262-646-2771",
            "fax_number": "262-646-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAFIELD DENTAL SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-07",
        "last_updated": "2016-07-07",
        "status": "A",
        "authorized_official_last_name": "POTRYKUS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-646-2771",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delafield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; 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.