Individual provider Active NPI

Linda Jean Terlecke, DDS

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1679754774
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3040-015 Issued in WI
Practice address
3968 N 68TH St
Milwaukee, WI 53216-2012
Phone
(414) 463-5480
Fax
(414) 463-8003
NPI assigned
Nov 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3040-015 WI Primary

Addresses

Primary practice location

3968 N 68TH St
Milwaukee, WI 53216-2012

Mailing address

3968 N 68TH St
Milwaukee, WI 53216-2012
Phone (414) 463-5480

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

LicenseStateTypeSpecialty
3040-015WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1679754774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3968 N 68TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162012",
            "telephone_number": "414-463-5480",
            "fax_number": "414-463-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3968 N 68TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162012",
            "telephone_number": "414-463-5480",
            "fax_number": "414-463-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERLECKE",
        "first_name": "LINDA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "3040-015",
            "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 Nov 16, 2007; 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.