NPIMap

Organization Active NPI

Deerwood Orthodontics, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Mount Pleasant, WI
National Provider Identifier
1700534294
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
DEERWOOD ORTHODONTICS, LLC
Practice address
1532 S Green Bay Rd Ste 100
Mount Pleasant, WI 53406-4468
Phone
(262) 632-3300
NPI assigned
Mar 14, 2022
Organization subpart
Yes
Parent organization
DEERWOOD ORTHODONTICS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

1532 S Green Bay Rd Ste 100
Mount Pleasant, WI 53406-4468

Mailing address

1532 S Green Bay Rd Ste 100
Mount Pleasant, WI 53406-4468
Phone (262) 632-3300

Other names 1

  • Deerwood Orthodontics Racine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Deerwood Orthodontics LLC10 organizations share this tax ID, including this one
Part of
Deerwood Orthodontics LLC

Other organizations with this tax ID 9

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

Locations

1532 S Green Bay Rd
Ste 100
Mount Pleasant, WI 53406
Phone (262) 632-3300

NPI Registry JSON

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1700534294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 S GREEN BAY RD STE 100",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534064468",
            "telephone_number": "262-632-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 S GREEN BAY RD STE 100",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534064468",
            "telephone_number": "262-632-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEERWOOD ORTHODONTICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEERWOOD ORTHODONTICS, LLC",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deerwood Orthodontics Racine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.