Active NPI
George Richard Ledvina III, DDS
- General Practice Dentistry
- Milwaukee, WI
National Provider Identifier
1639338445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0003062
- Practice address
- 9401 W Beloit Rd
#310
Milwaukee, WI 53227-4357 - Phone
- (414) 545-0147
- NPI assigned
- Jun 6, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0003062 | WI | Primary |
Addresses
Primary practice location
9401 W Beloit Rd
#310
Milwaukee, WI 53227-4357
Mailing address
9401 W Beloit Rd
#310
Milwaukee, WI 53227-4357
Phone (414) 545-0147
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0003062 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212710400000",
"number": "1639338445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9401 W BELOIT RD",
"address_2": "#310",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532274357",
"telephone_number": "414-545-0147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9401 W BELOIT RD",
"address_2": "#310",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532274357",
"telephone_number": "414-545-0147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEDVINA",
"first_name": "GEORGE",
"middle_name": "RICHARD",
"name_suffix": "III",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-06",
"last_updated": "2008-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "0003062",
"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 Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.