NPIMap

Organization Active NPI

Dentaquest, LLC

  • Health Maintenance Organization
  • Mequon, WI
National Provider Identifier
1891958930
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
DENTAQUEST, LLC
Practice address
12121 Corporate Pkwy
Mequon, WI 53092-3332
Phone
(262) 834-3553
Fax
(242) 241-7366
NPI assigned
Jul 9, 2008
Last updated
Mar 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Authorized official

Name
Mrs. Carrie Lynn Fritz
Title
Manager, Provider Networks
Phone
(262) 834-3553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

12121 Corporate Pkwy
Mequon, WI 53092-3332

Mailing address

12121 Corporate Pkwy
Mequon, WI 53092-3332
Phone (262) 834-3553

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267574400000",
    "number": "1891958930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 CORPORATE PKWY",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923332",
            "telephone_number": "262-834-3553",
            "fax_number": "242-241-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 CORPORATE PKWY",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923332",
            "telephone_number": "262-834-3553",
            "fax_number": "242-241-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAQUEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2010-03-03",
        "status": "A",
        "authorized_official_last_name": "FRITZ",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MANAGER, PROVIDER NETWORKS",
        "authorized_official_telephone_number": "262-834-3553",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.