NPIMap

Organization Active NPI

Renita C Burrell, DDS, Ms, S.C.

  • Dental Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1598040263
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
6086-15 Issued in WI
Legal business name
RENITA C BURRELL, DDS, MS, S.C.
Practice address
2457 N Mayfair Rd Ste 102
Milwaukee, WI 53226-1405
Phone
(414) 257-1221
NPI assigned
Oct 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
Dr. Renita C Burrell, DDS, MSNPI 1326248881
Title
Periodontist
Phone
(262) 384-0092

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
Dental Clinic/Center 261QD0000X 6086-15 WI Primary

Addresses

Primary practice location

2457 N Mayfair Rd Ste 102
Milwaukee, WI 53226-1405

Mailing address

2457 N Mayfair Rd Ste 102
Milwaukee, WI 53226-1405

National Provider Directory

National Provider Directory

Locations

2457 N Mayfair Rd
Ste 102
Wauwatosa, WI 53226
Phone (414) 257-1221

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": "1318464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1598040263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2457 N MAYFAIR RD STE 102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532261405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2457 N MAYFAIR RD STE 102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532261405",
            "telephone_number": "414-257-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENITA C BURRELL, DDS, MS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-13",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "BURRELL",
        "authorized_official_first_name": "RENITA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "262-384-0092",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WI",
            "license": "6086-15",
            "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 Oct 13, 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.