Keystone Bayview LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KEYSTONE BAYVIEW LLC

Practice address

3380 S Kinnickinnic Ave
Milwaukee, WI 53207-3159

Phone

(262) 873-0510

NPI assigned

Oct 12, 2022

Organization subpart

No

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

Authorized official

Name

Christopher Potrykus, DDS

Title

Owner

Phone

(262) 873-0510

Specialties & licenses 1

Addresses

Other names 1

• Bayview Dental Care Doing business as

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1609592534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 180163",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530180163",
            "telephone_number": "262-873-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 S KINNICKINNIC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532073159",
            "telephone_number": "262-873-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE BAYVIEW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "POTRYKUS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-873-0510",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayview Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Dental Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.