NPIMap

Organization Active NPI

Endodontic Associates, LTD.

  • Endodontics
  • Brookfield, WI
National Provider Identifier
1417002452
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
ENDODONTIC ASSOCIATES, LTD.
Practice address
12660 W North Ave
Building D
Brookfield, WI 53005-4633
Phone
(262) 432-1600
Fax
(262) 432-0227
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Todd Keith Engel, D.D.S.NPI 1154415263
Title
Secretary to Board
Phone
(262) 432-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X WI Primary

Addresses

Primary practice location

12660 W North Ave
Building D
Brookfield, WI 53005-4633

Mailing address

12660 W North Ave
Building D
Brookfield, WI 53005-4633
Phone (262) 432-1600

National Provider Directory

National Provider Directory

Locations

12660 W North Ave
Bldg D
Brookfield, WI 53005
Phone (262) 432-1600

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417002452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12660 W NORTH AVE",
            "address_2": "BUILDING D",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054633",
            "telephone_number": "262-432-1600",
            "fax_number": "262-432-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12660 W NORTH AVE",
            "address_2": "BUILDING D",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054633",
            "telephone_number": "262-432-1600",
            "fax_number": "262-432-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTIC ASSOCIATES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENGEL",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "SECRETARY TO BOARD",
        "authorized_official_telephone_number": "262-432-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.