NPIMap

Organization Active NPI

Kimberly Dental Associates LLP

  • General Practice Dentistry
  • Kimberly, WI
National Provider Identifier
1790798056
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3151 Issued in WI
Legal business name
KIMBERLY DENTAL ASSOCIATES LLP
Practice address
203 W Kimberly Ave
Kimberly, WI 54136
Phone
(920) 788-1263
Fax
(920) 788-0333
NPI assigned
Aug 15, 2006
Organization subpart
No

Practitioners 2

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

National Provider Directory

National Provider Directory

Locations

203 W Kimberly Ave
Kimberly, WI 54136
Phone (920) 788-1263

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
Dr. Edward Theodore Bekx, DDSNPI 1548273808
Title
Partner
Phone
(920) 788-1263

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 3151 WI Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 4541 WI

Addresses

Primary practice location

203 W Kimberly Ave
Kimberly, WI 54136

Mailing address

PO Box 100
Kimberly, WI 54136
Phone (920) 788-1263

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790798056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "KIMBERLY",
            "state": "WI",
            "postal_code": "54136",
            "telephone_number": "920-788-1263",
            "fax_number": "920-788-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W KIMBERLY AVE",
            "city": "KIMBERLY",
            "state": "WI",
            "postal_code": "54136",
            "telephone_number": "920-788-1263",
            "fax_number": "920-788-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY DENTAL ASSOCIATES LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEKX",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "THEODORE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "920-788-1263",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3151",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4541",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kimberly, 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.