NPIMap

Organization Active NPI

Deerwood Orthodontics, LLC

Doing business as Deerwood Orthodontics Stone Ridge

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Waukesha, WI
National Provider Identifier
1962150458
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
DEERWOOD ORTHODONTICS, LLC
Doing business as
Deerwood Orthodontics Stone Ridge
Practice address
N14W23833 Stone Ridge Dr Ste 100
Waukesha, WI 53188-1189
Phone
(262) 524-1072
Fax
(262) 524-9225
NPI assigned
Mar 14, 2022
Last updated
Mar 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
DEERWOOD ORTHODONTICS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X Primary

Addresses

Primary practice location

N14W23833 Stone Ridge Dr Ste 100
Waukesha, WI 53188-1189

Mailing address

N14W23833 Stone Ridge Dr Ste 100
Waukesha, WI 53188-1189
Phone (262) 524-1072

Other names 1

  • Deerwood Orthodontics Stone Ridge Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wisconsin Dental Groupsc10 organizations share this tax ID, including this one
Part of
Wisconsin Dental Groupsc

Other organizations with this tax ID 9

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

Locations

N14W23833 Stone Ridge Dr
Ste 100
Waukesha, WI 53188
Phone (262) 524-1072

NPI Registry JSON

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1962150458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N14W23833 STONE RIDGE DR STE 100",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881189",
            "telephone_number": "262-524-1072",
            "fax_number": "262-524-9225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N14W23833 STONE RIDGE DR STE 100",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881189",
            "telephone_number": "262-524-1072",
            "fax_number": "262-524-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEERWOOD ORTHODONTICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEERWOOD ORTHODONTICS, LLC",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deerwood Orthodontics Stone Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.