NPIMap

Organization Active NPI

Carolyn Griffin DDS LLC

Doing business as Lake Bluff Dental

  • Prosthodontics
  • Shorewood, WI
National Provider Identifier
1811426810
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
7054-15 Issued in WI
Legal business name
CAROLYN GRIFFIN DDS LLC
Doing business as
Lake Bluff Dental
Practice address
1720 E Lake Bluff Blvd
Shorewood, WI 53211-1517
Phone
(414) 962-1800
Fax
(414) 962-2302
NPI assigned
Jun 5, 2017
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Dr. Carolyn Griffin, DDSNPI 1336589134
Title
Dentist
Phone
(414) 962-1800

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 7054-15 WI Primary

Addresses

Primary practice location

1720 E Lake Bluff Blvd
Shorewood, WI 53211-1517

Mailing address

4018 E Allerton Ave
Cudahy, WI 53110-1205
Phone (262) 945-8227

Other names 2

  • Lake Bluff Dental Doing business as
  • Lake Bluff Prosthodontics Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1811426810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4018 E ALLERTON AVE",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531101205",
            "telephone_number": "262-945-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E LAKE BLUFF BLVD",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532111517",
            "telephone_number": "414-962-1800",
            "fax_number": "414-962-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLYN GRIFFIN DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-05",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "414-962-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WI",
            "license": "7054-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Bluff Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Bluff Prosthodontics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Shorewood, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.