NPIMap

Organization Active NPI

Dentamed Healthcare LLC

  • Dental Clinic/Center
  • Brown Deer, WI
National Provider Identifier
1851832943
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DENTAMED HEALTHCARE LLC
Practice address
3900 W Brown Deer Rd
Suite a, #212
Brown Deer, WI 53209-1220
Phone
(612) 568-4298
NPI assigned
Mar 9, 2017
Last updated
Mar 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Authorized official

Name
Elaye Okunseri
Title
Executive Director
Phone
(612) 568-4298

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

3900 W Brown Deer Rd
Suite a, #212
Brown Deer, WI 53209-1220

Mailing address

3900 W Brown Deer Rd
Suite a, #212
Brown Deer, WI 53209-1220

National Provider Directory

National Provider Directory

Locations

3900 W Brown Deer Rd
Ste A
Milwaukee, WI 53209
Phone (612) 568-4298

Practitioners & affiliated clinicians

Practitioners 1

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": "1489017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1851832943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W BROWN DEER RD",
            "address_2": "SUITE A, #212",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W BROWN DEER RD",
            "address_2": "SUITE A, #212",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091220",
            "telephone_number": "612-568-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAMED HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A",
        "authorized_official_last_name": "OKUNSERI",
        "authorized_official_first_name": "ELAYE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "612-568-4298"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brown Deer, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.