NPIMap

Organization Active NPI

Children's Medical Group

Doing business as Children's Dental Center - Midtown

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1881953776
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CHILDREN'S MEDICAL GROUP
Doing business as
Children's Dental Center - Midtown
Practice address
5433 W Fond Du Lac Ave
Milwaukee, WI 53216-1382
Phone
(414) 445-6500
Fax
(414) 445-6618
NPI assigned
May 11, 2012
Last updated
Sep 7, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
CHILDREN'S HOSPITAL AND HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Authorized official

Name
Smriti Khare, M.D.
Title
President - Children's Medical Grou
Phone
(414) 266-6404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

5433 W Fond Du Lac Ave
Milwaukee, WI 53216-1382

Mailing address

9000 W Wisconsin Ave
Ms 958
Milwaukee, WI 53226-4874
Phone (414) 445-6500

Other names 1

  • Children's Dental Center - Midtown Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CMG Inc Pediatric CNSL38 organizations share this tax ID, including this one
Part of
Children's Hospital of Wiscosnin Inc

Other organizations with this tax ID 37

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

View all 37

Locations

9000 W Wisconsin Ave
#958
Wauwatosa, WI 53226
Phone (414) 266-7615

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": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1881953776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-445-6500",
            "fax_number": "414-445-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5433 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161382",
            "telephone_number": "414-445-6500",
            "fax_number": "414-445-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S HOSPITAL AND HEALTH SYSTEM",
        "enumeration_date": "2012-05-11",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "KHARE",
        "authorized_official_first_name": "SMRITI",
        "authorized_official_title_or_position": "PRESIDENT - CHILDREN'S MEDICAL GROU",
        "authorized_official_telephone_number": "414-266-6404",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Dental Center - Midtown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.