NPIMap

Organization Active NPI

Quirt Family Dentistry, SC

  • General Practice Dentistry
  • Pleasant Prairie, WI
National Provider Identifier
1891117495
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
QUIRT FAMILY DENTISTRY, SC
Practice address
10288 77TH St
Suite 300
Pleasant Prairie, WI 53158-1142
Phone
(262) 612-3325
NPI assigned
Jan 16, 2014
Organization subpart
Yes
Parent organization
QUIRT FAMILY DENTISTRY, SCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Authorized official

Name
Lindsay Bearden
Title
Insurance/Credentialing
Phone
(217) 540-5100

Specialties & licenses 1

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

Addresses

Primary practice location

10288 77TH St
Suite 300
Pleasant Prairie, WI 53158-1142

Mailing address

10288 77TH St
Suite 300
Pleasant Prairie, WI 53158-1142
Phone (262) 612-3325

Other names 1

  • Prairie Ridge Dental Care 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

Locations

10288 77th St
Ste 300
Pleasant Prairie, WI 53158
Phone (262) 612-3325

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": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389830400000",
    "number": "1891117495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10288 77TH ST",
            "address_2": "SUITE 300",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581142",
            "telephone_number": "262-612-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10288 77TH ST",
            "address_2": "SUITE 300",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581142",
            "telephone_number": "262-612-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUIRT FAMILY DENTISTRY, SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUIRT FAMILY DENTISTRY, SC",
        "enumeration_date": "2014-01-16",
        "last_updated": "2014-01-16",
        "status": "A",
        "authorized_official_last_name": "BEARDEN",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "INSURANCE/CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "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": "Prairie Ridge Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pleasant Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; 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.