Mi Dentista LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5729-015 Issued in WI

Legal business name

MI DENTISTA LLC

Practice address

4801 Cottage Grove Rd Ste D
Madison, WI 53716-1349

Phone

(608) 658-4600

NPI assigned

Nov 25, 2014

Organization subpart

No

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

Authorized official

Name

Matthew Kutz, DDS

Title

Owner

Phone

(608) 658-4600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1891192415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 COTTAGE GROVE RD STE D",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537161349",
            "telephone_number": "608-658-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 COTTAGE GROVE RD STE D",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537161349",
            "telephone_number": "608-658-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI DENTISTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "KUTZ",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-658-4600",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5729-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonia K Meyers, M.D.
• Tracy Meyers
• Michael Stephen Meyn, MD PHD
• Joshua D Mezrich
• MG Counseling & Wellness, LLC
• Istiaq H Mian, M.D.
• Marmar Miar, DDS
• Elizabeth Jean Miazga, PHARM.D.
• Carolyn M Micek, CA
• Mark Micek, MD

• General Practice Dentistry in Madison, WI
• Providers in Madison, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.