NPIMap

Organization Active NPI

The Fun Kids Dentist, S.C.

  • Dentist
  • Brookfield, WI
National Provider Identifier
1568522720
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5001405 Issued in WI
Legal business name
THE FUN KIDS DENTIST, S.C.
Practice address
16655 Bluemound Rd
Suite 380
Brookfield, WI 53005
Phone
(262) 786-1270
Fax
(262) 786-0023
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Authorized official

Name
Dr. Edward J. Trochlell, D.D.S.NPI 1518026624
Title
President/Owner
Phone
(262) 786-1270

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 5001405 WI Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 50011629 WI

Addresses

Primary practice location

16655 Bluemound Rd
Suite 380
Brookfield, WI 53005

Mailing address

16655 Bluemound Rd
Suite 380
Brookfield, WI 53005
Phone (262) 786-1270

National Provider Directory

National Provider Directory

Locations

16655 W Bluemound Rd
Ste 380
Brookfield, WI 53005
Phone (262) 786-1270

Practitioners & affiliated clinicians

Practitioners 7

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": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401148800000",
    "number": "1568522720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16655 BLUEMOUND RD",
            "address_2": "SUITE 380",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53005",
            "telephone_number": "262-786-1270",
            "fax_number": "262-786-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16655 BLUEMOUND RD",
            "address_2": "SUITE 380",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53005",
            "telephone_number": "262-786-1270",
            "fax_number": "262-786-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FUN KIDS DENTIST, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2014-05-27",
        "status": "A",
        "authorized_official_last_name": "TROCHLELL",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "262-786-1270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "5001405",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "50011629",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.