NPIMap

Organization Active NPI

Quirt Family Dentistry

Doing business as RLJ Dental - Green Bay

  • General Practice Dentistry
  • Green Bay, WI
National Provider Identifier
1417414889
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
QUIRT FAMILY DENTISTRY
Doing business as
RLJ Dental - Green Bay
Practice address
709 S Oneida St
Green Bay, WI 54304-2475
Phone
(920) 494-0554
NPI assigned
Feb 21, 2019
Last updated
Feb 21, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
QUIRT FAMILY DENTISTRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Authorized official

Name
Tabatha Lemke
Title
Credentialing Coordinator
Phone
(217) 540-6078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

709 S Oneida St
Green Bay, WI 54304-2475

Mailing address

709 S Oneida St
Green Bay, WI 54304-2475

Other names 1

  • RLJ Dental - Green Bay Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Quirt Family Dentistry SC32 organizations share this tax ID, including this one
Part of
Quirt Family Dentistry SC

Other organizations with this tax ID 31

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

View all 31

Locations

709 S Oneida St
Green Bay, WI 54304
Phone (920) 405-0050

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.

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": "1550707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550707200000",
    "number": "1417414889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 S ONEIDA ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543042475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 S ONEIDA ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543042475",
            "telephone_number": "920-494-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUIRT FAMILY DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUIRT FAMILY DENTISTRY",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-02-21",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6078"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RLJ Dental - Green Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.