NPIMap

Organization Active NPI

Quirt Family Dentistry, SC

Doing business as Quirt Family Dentistry - Wittenberg

  • General Practice Dentistry
  • Wittenberg, WI
National Provider Identifier
1962777466
Registry record updated Mar 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
QUIRT FAMILY DENTISTRY, SC
Doing business as
Quirt Family Dentistry - Wittenberg
Practice address
200 S Cherry St
Wittenberg, WI 54499-9051
Phone
(715) 253-2694
NPI assigned
Mar 16, 2012
Last updated
Mar 16, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
QUIRT FAMILY DENTISTRY, SCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2012

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

Authorized official

Name
Kim Wilson
Title
Credentialing Coordinator
Phone
(217) 540-5170

Specialties & licenses 1

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

Addresses

Primary practice location

200 S Cherry St
Wittenberg, WI 54499-9051

Mailing address

200 S Cherry St
Wittenberg, WI 54499-9051
Phone (715) 253-2694

Other names 1

  • Quirt Family Dentistry - Wittenberg Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Quirt Family Dentistry SC32 organizations share this tax ID, including this one
Part of
Quirt Family Dentistry SC

Other organizations with this tax ID 31

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

View all 31

Locations

200 S Cherry St
Wittenberg, WI 54499
Phone (715) 253-2694

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, 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": "1331856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1962777466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S CHERRY ST",
            "city": "WITTENBERG",
            "state": "WI",
            "postal_code": "544999051",
            "telephone_number": "715-253-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S CHERRY ST",
            "city": "WITTENBERG",
            "state": "WI",
            "postal_code": "544999051",
            "telephone_number": "715-253-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUIRT FAMILY DENTISTRY, SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUIRT FAMILY DENTISTRY, SC",
        "enumeration_date": "2012-03-16",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5170"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quirt Family Dentistry - Wittenberg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wittenberg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.