NPIMap

Organization Active NPI

La Petite Dentistry

  • Pediatric Dentistry
  • Hudson, WI
National Provider Identifier
1467747303
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
6499-015 Issued in WI
Legal business name
LA PETITE DENTISTRY
Practice address
131 Carmichael Rd Ste 200
Hudson, WI 54016-8271
Phone
(855) 527-3848
Fax
(855) 457-3329
NPI assigned
Jun 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Authorized official

Name
Dr. Andy Mancini, DMD, MBANPI 1487813473
Title
Owner/President
Phone
(855) 527-3848

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 6499-015 WI Primary

Addresses

Primary practice location

131 Carmichael Rd Ste 200
Hudson, WI 54016-8271

Mailing address

131 Carmichael Rd Ste 200
Hudson, WI 54016-8271
Phone (855) 527-3848

National Provider Directory

National Provider Directory

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": "1308268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1467747303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 CARMICHAEL RD STE 200",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168271",
            "telephone_number": "855-527-3848",
            "fax_number": "855-457-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 CARMICHAEL RD STE 200",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168271",
            "telephone_number": "855-527-3848",
            "fax_number": "855-457-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PETITE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-17",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "MANCINI",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "855-527-3848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MBA"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "6499-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.