Active NPI
Adam T. Quetsch, DDS
- General Practice Dentistry
- Oconomowoc, WI
National Provider Identifier
1891300455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1002435-15
- Practice address
- 819 Summit Ave
Oconomowoc, WI 53066-3998 - Phone
- (262) 333-0149
- NPI assigned
- Sep 10, 2020
- Last updated
- Sep 10, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1002435-15 | WI | Primary |
Addresses
Primary practice location
819 Summit Ave
Oconomowoc, WI 53066-3998
Mailing address
1607A N Astor St
Milwaukee, WI 53202-2107
Phone (630) 770-4457
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1002435-15 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1891300455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1607A N ASTOR ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532022107",
"telephone_number": "630-770-4457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "819 SUMMIT AVE",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530663998",
"telephone_number": "262-333-0149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUETSCH",
"first_name": "ADAM",
"middle_name": "T.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-10",
"last_updated": "2020-09-10",
"certification_date": "2020-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "1002435-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oconomowoc, WI
- Prohealth Oconomowoc Memorial Hospital, Inc. (ProHealth Pharmacy - Oconomowoc)
- Prohealth Oconomowoc Memorial Hospital, Inc.
- Beth Provost, LCSW, LMSW
- Purity Dialysis Centers, Inc (Oconomowoc Dialysis Center)
- Quad/Med, LLC
- Brian James Quick, LPC
- Radiology Consultants of Wisconsin
- Raina L. Hollenbaugh, M.D., S.C.
- Francis P Ramirez, DMD
- Karen K Rasmussen, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.