NPIMap

Organization Active NPI

East Park Dental, LLC

  • General Practice Dentistry
  • Madison, WI
National Provider Identifier
1508598202
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EAST PARK DENTAL, LLC
Practice address
5100 Eastpark Blvd
Suite 110
Madison, WI 53718
Phone
(608) 222-8232
NPI assigned
Jun 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Authorized official

Name
Karl WeaverNPI 1629157847
Title
DDS
Phone
(608) 222-8232

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5100 Eastpark Blvd
Suite 110
Madison, WI 53718

Mailing address

5100 Eastpark Blvd.
Suite 110
Madison, WI 53718
Phone (608) 222-8232

National Provider Directory

National Provider Directory

Locations

5100 Eastpark Blvd
Ste 110
Madison, WI 53718
Phone (608) 222-8232

Practitioners & affiliated clinicians

Practitioners 1

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": "1656547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656547200000",
    "number": "1508598202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 EASTPARK BLVD.",
            "address_2": "SUITE 110",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53718",
            "telephone_number": "608-222-8232",
            "fax_number": "608-244-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 EASTPARK BLVD",
            "address_2": "SUITE 110",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53718",
            "telephone_number": "608-222-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PARK DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "KARL",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "608-222-8232"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.