NPIMap

Organization Active NPI

Affordable Dentures - Eau Claire, S.C.

  • General Practice Dentistry
  • Eau Claire, WI
National Provider Identifier
1932467222
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6330-015 Issued in WI
Legal business name
AFFORDABLE DENTURES - EAU CLAIRE, S.C.
Practice address
4850 Keystone Xing
Eau Claire, WI 54701-5076
Phone
(715) 855-1020
NPI assigned
Apr 25, 2012
Last updated
Apr 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Authorized official

Name
Dr. Phillip Douglas, DDSNPI 1982858247
Title
Practice Owner
Phone
(715) 855-1020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6330-015 WI Primary

Addresses

Primary practice location

4850 Keystone Xing
Eau Claire, WI 54701-5076

Mailing address

4850 Keystone Xing
Eau Claire, WI 54701-5076

National Provider Directory

National Provider Directory

Locations

4850 Keystone Xing
Eau Claire, WI 54701
Phone (715) 855-1020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1932467222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 KEYSTONE XING",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547015076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 KEYSTONE XING",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547015076",
            "telephone_number": "715-855-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES - EAU CLAIRE, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "715-855-1020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6330-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.