Individual provider Active NPI

Susann Bordini Norwick, DDS,MS

  • Pediatric Dentistry
  • Waukesha, WI
National Provider Identifier
1487745394
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2173 Issued in WI
Practice address
2727 N Grandview Blvd
Suite 206
Waukesha, WI 53188-6100
Phone
(262) 542-8402
Fax
(262) 542-4436
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 2173 WI Primary

Addresses

Primary practice location

2727 N Grandview Blvd
Suite 206
Waukesha, WI 53188-6100

Mailing address

2727 N Grandview Blvd
Suite 206
Waukesha, WI 53188-6100
Phone (262) 542-8402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2173WIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Waukesha Pediatric Dental Care SC Pediatric Dentistry Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487745394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 N GRANDVIEW BLVD",
            "address_2": "SUITE 206",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531886100",
            "telephone_number": "262-542-8402",
            "fax_number": "262-542-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 N GRANDVIEW BLVD",
            "address_2": "SUITE 206",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531886100",
            "telephone_number": "262-542-8402",
            "fax_number": "262-542-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORWICK",
        "first_name": "SUSANN",
        "middle_name": "BORDINI",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "2173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.