NPIMap

Organization Active NPI

Advanced Dental Specialists, LLC

Doing business as Advanced Dental Specialists

  • Oral and Maxillofacial Surgery (Dentist)
  • Milwaukee, WI
National Provider Identifier
1972773588
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ADVANCED DENTAL SPECIALISTS, LLC
Doing business as
Advanced Dental Specialists
Practice address
9052 N Deerbrook TRL
Milwaukee, WI 53223-2474
Phone
(414) 357-2040
NPI assigned
Mar 11, 2008
Last updated
Mar 31, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

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

Authorized official

Name
Peter Young
Title
Vice President of Operations
Phone
(414) 357-2040

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X NU
Periodontics 1223P0300X NU
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU Primary

Addresses

Primary practice location

9052 N Deerbrook TRL
Milwaukee, WI 53223-2474

Mailing address

9052 N Deerbrook TRL
Milwaukee, WI 53223-2474
Phone (414) 357-2040

Other names 1

  • Advanced Dental Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Advanced Dental Specialists LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

Subparts reporting this organization as parent 11

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269993600000",
    "number": "1972773588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9052 N DEERBROOK TRL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532232474",
            "telephone_number": "414-357-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9052 N DEERBROOK TRL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532232474",
            "telephone_number": "414-357-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2010-03-31",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "414-357-2040"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dental Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; 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.