NPIMap

Organization Active NPI

Mid-Towne Dental Associates, S.C.

  • General Practice Dentistry
  • Wisconsin Rapids, WI
National Provider Identifier
1679606537
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5001043 Issued in WI
Legal business name
MID-TOWNE DENTAL ASSOCIATES, S.C.
Practice address
1730 7TH St S
Wisconsin Rapids, WI 54494-5238
Phone
(715) 423-3322
Fax
(715) 424-3786
NPI assigned
Mar 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert E McGrath, D.D.S.NPI 1497843429
Title
Owner
Phone
(715) 423-3322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5001043 WI Primary

Addresses

Primary practice location

1730 7TH St S
Wisconsin Rapids, WI 54494-5238

Mailing address

1730 7TH St S
P.O. Box 1178
Wisconsin Rapids, WI 54494-5238
Phone (715) 423-3322

Other identifiers 1

IdentifierTypeStateIssuer
38378500MedicaidWI

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679606537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 7TH ST S",
            "address_2": "P.O. BOX 1178",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544945238",
            "telephone_number": "715-423-3322",
            "fax_number": "715-424-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 7TH ST S",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544945238",
            "telephone_number": "715-423-3322",
            "fax_number": "715-424-3786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-TOWNE DENTAL ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCGRATH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-423-3322",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38378500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.