NPIMap

Organization Active NPI

Quirt Family Dentistry

  • General Practice Dentistry
  • Menasha, WI
National Provider Identifier
1881151256
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
QUIRT FAMILY DENTISTRY
Practice address
1155 Wittmann Dr
Menasha, WI 54952-3607
Phone
(920) 725-5584
NPI assigned
Feb 21, 2019
Organization subpart
Yes
Parent organization
QUIRT FAMILY DENTISTRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Authorized official

Name
Tabatha Lemke
Title
Credentialing Coordinator
Phone
(217) 540-6078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1155 Wittmann Dr
Menasha, WI 54952-3607

Mailing address

1155 Wittmann Dr
Menasha, WI 54952-3607

Other names 1

  • RLJ Dental - Menasha Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Quirt Family Dentistry SC32 organizations share this tax ID, including this one
Part of
Quirt Family Dentistry SC

Other organizations with this tax ID 31

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

View all 31

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550707200000",
    "number": "1881151256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 WITTMANN DR",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549523607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 WITTMANN DR",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549523607",
            "telephone_number": "920-725-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUIRT FAMILY DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUIRT FAMILY DENTISTRY",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-02-21",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6078"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RLJ Dental - Menasha",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Menasha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.