NPIMap

Organization Active NPI

Deerwood Orthodontics, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Menomonee Falls, WI
National Provider Identifier
1720118987
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
N80W17707 Custer LN
Menomonee Falls, WI 53051-3630
Phone
(262) 502-0605
Fax
(262) 415-1266
NPI assigned
Mar 6, 2007
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: 193200000X MULTI-SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

N80W17707 Custer LN
Menomonee Falls, WI 53051-3630

Mailing address

N80W17707 Custer LN
Menomonee Falls, WI 53051-3630
Phone (262) 502-0605

Other names 1

  • Deerwood Orthodontics Menomonee Falls 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.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1720118987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N80W17707 CUSTER LN",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530513630",
            "telephone_number": "262-502-0605",
            "fax_number": "262-415-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N80W17707 CUSTER LN",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530513630",
            "telephone_number": "262-502-0605",
            "fax_number": "262-415-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEERWOOD ORTHODONTICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEERWOOD ORTHODONTICS, LLC",
        "enumeration_date": "2007-03-06",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deerwood Orthodontics Menomonee Falls",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Menomonee Falls, 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.