Organization Active NPI

Ortho 360 LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Milwaukee, WI
National Provider Identifier
1497466890
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
ORTHO 360 LLC
Practice address
10809 W Lincoln Ave
Milwaukee, WI 53227-1177
Phone
(877) 795-0360
NPI assigned
Dec 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Authorized official

Name
Ivana Bueno
Title
Director
Phone
(773) 798-9382

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

10809 W Lincoln Ave
Milwaukee, WI 53227-1177

Mailing address

10809 W Lincoln Ave
Milwaukee, WI 53227-1177

National Provider Directory

National Provider Directory

Locations

10809 W Lincoln Ave
Milwaukee, WI 53227
Phone (877) 795-0360

NPI Registry JSON

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1497466890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10809 W LINCOLN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532271177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10809 W LINCOLN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532271177",
            "telephone_number": "877-795-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO 360 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "BUENO",
        "authorized_official_first_name": "IVANA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-798-9382"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.