Wisconsin Smiles

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

WISCONSIN SMILES

Doing business as

American Dental Group

Practice address

6719 W Capitol Dr
Milwaukee, WI 53216-2041

Phone

(414) 464-6300

Fax

(414) 464-2874

NPI assigned

Oct 8, 2020

Organization subpart

Yes

Parent organization

WISCONSIN SMILESAs reported in NPPES

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

Authorized official

Name

Dr. Hidayathulla Khan, DMD

Title

President

Phone

(224) 766-9876

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• American Dental Group Doing business as

Tax ID family

Wisconsin Smiles2 organizations share this tax ID, including this one

Part of

Wisconsin Smiles

Other organizations with this tax ID 1

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

• Wisconsin Smiles

  • Dental Clinic/Center
  • Racine, WI
  • NPI 1457905861
  NPD tax ID

Locations

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.

• Wisconsin Smiles

  • Dental Clinic/Center
  • Racine, WI
  • NPI 1457905861
  NPPES parent name

Practitioners 2

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

• Munir A Chaudhry, DDS

  • General Practice Dentistry
  • Milwaukee, WI
  • NPI 1467638296
  NPD (past)
• Tanwir H Syed

  • Dentist
  • Milwaukee, WI
  • NPI 1679561724
  NPD (past)

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1467059865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6719 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162041",
            "telephone_number": "414-464-6300",
            "fax_number": "414-464-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162041",
            "telephone_number": "414-464-6300",
            "fax_number": "414-464-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN SMILES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WISCONSIN SMILES",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "HIDAYATHULLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "224-766-9876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS-NPI",
            "identifier": "1699128082",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wisconsin Outreach for Mothers and Babies LLC (Womb LLC)
• Wisconsin Renal Care Group, L.L.C. (Fresenius Kidney Care Shorewood)
• Wisconsin Renal Care Group, L.L.C. (WRCG Milwaukee)
• Wisconsin Retina, S.C.
• Wisconsin School of Professional Psychology (WSPP Psychology Center)
• Wisconsin Special Security Services LLC
• Wisconsin Stress Control Center, LTD
• Wisconsin Surgery Center LLC
• Wisconsin Telehealthcare Network
• Wisconsin Transport Systems LLC

• Dental Clinic/Center in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Dental Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.