NPIMap

Organization Active NPI

Orthodontic Experts of Wisconsin, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Hales Corners, WI
National Provider Identifier
1942949573
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
ORTHODONTIC EXPERTS OF WISCONSIN, LLC
Practice address
5778 S 108TH St
Hales Corners, WI 53130-1947
Phone
(414) 600-0120
NPI assigned
Jun 1, 2022
Organization subpart
Yes
Parent organization
ORTHODONTIC EXPERTS OF WISCONSIN, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Authorized official

Name
Monika Bzdal
Title
VP of Support Services
Phone
(815) 340-1046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

5778 S 108TH St
Hales Corners, WI 53130-1947

Mailing address

1250 W Northwest Hwy
Mount Prospect, IL 60056-2274
Phone (847) 749-4340

National Provider Directory

National Provider Directory
Tax ID family
Orthodontic Experts of Wisconsin LLC5 organizations share this tax ID, including this one
Part of
Orthodontic Experts of Wisconsin LLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5778 S 108th St
Hales Corners, WI 53130
Phone (414) 600-0120

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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1942949573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W NORTHWEST HWY",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600562274",
            "telephone_number": "847-749-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5778 S 108TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301947",
            "telephone_number": "414-600-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC EXPERTS OF WISCONSIN, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHODONTIC EXPERTS OF WISCONSIN, LLC",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "BZDAL",
        "authorized_official_first_name": "MONIKA",
        "authorized_official_title_or_position": "VP OF SUPPORT SERVICES",
        "authorized_official_telephone_number": "815-340-1046"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hales Corners, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.