Smile Wisconsin LTD

Primary specialty

DentistTaxonomy code 122300000X

License

6817-15 Issued in WI

Legal business name

SMILE WISCONSIN LTD

Practice address

250 E Wisconsin Ave
Suite 1800
Milwaukee, WI 53202-4232

Phone

(888) 833-8441

Fax

(888) 330-4331

NPI assigned

Dec 12, 2011

Last updated

Dec 12, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Solomon K. Pesis, DDS

Title

Dental Director

Phone

(888) 833-8441

Specialties & licenses 1

Addresses

Tax ID family

Smile Wisconsin LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Smile Wisconsin LTD

  • General Practice Dentistry
  • Manitowoc, WI
  • NPI 1336390327
  NPD tax ID

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1689942195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33533 W 12 MILE RD",
            "address_2": "SUITE 150",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313354",
            "telephone_number": "888-833-8441",
            "fax_number": "888-330-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E WISCONSIN AVE",
            "address_2": "SUITE 1800",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024232",
            "telephone_number": "888-833-8441",
            "fax_number": "888-330-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE WISCONSIN LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "PESIS",
        "authorized_official_first_name": "SOLOMON",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "DENTAL DIRECTOR",
        "authorized_official_telephone_number": "888-833-8441",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6817-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shae Lynn Smetana, PA
• Stephen E Smetana I, DO
• Cory Smid
• Nancy Mary Smiegowski, MSN ANP-BC, GNP-BC
• Smile FX
• Smilex Dental LLC (Legacy Dental)
• Hannah Smiley
• Sakajha Smiley
• Luriel Smith-Harrison, M.D.
• Shantique Shanee Smith-Hayes

• Dentist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Dentist in Wisconsin

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