NPIMap

Organization Active NPI

Family Dental Arts, S.C.

  • General Practice Dentistry
  • Elkhorn, WI
National Provider Identifier
1972707297
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5608 Issued in WI
Legal business name
FAMILY DENTAL ARTS, S.C.
Practice address
209 Commerce CT
Elkhorn, WI 53121-4371
Phone
(262) 723-2900
Fax
(262) 723-6360
NPI assigned
Jun 12, 2007
Last updated
Oct 2, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Authorized official

Name
Dr. Chad M GrevingNPI 1265590806
Title
Owner
Phone
(262) 723-2900

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 Dentistry 1223G0001X 5608 WI Primary

Addresses

Primary practice location

209 Commerce CT
Elkhorn, WI 53121-4371

Mailing address

209 Commerce CT
Elkhorn, WI 53121-4371
Phone (262) 723-2900

National Provider Directory

National Provider Directory

Locations

209 E Commerce Ct
Elkhorn, WI 53121
Phone (262) 686-1388

Practitioners & affiliated clinicians

Practitioners 3

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": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1972707297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 COMMERCE CT",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214371",
            "telephone_number": "262-723-2900",
            "fax_number": "262-723-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 COMMERCE CT",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214371",
            "telephone_number": "262-723-2900",
            "fax_number": "262-723-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL ARTS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "GREVING",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-723-2900",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.