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DELAFIELD DENTAL SPECIALISTS LLC NPI 1407208002


NPI Information

NPI: 1407208002
Provider Name: DELAFIELD DENTAL SPECIALISTS LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 52D2083729

Address:
920 INDIAN SPRING DR
DELAFIELD, WI
ZIP 53018
Phone: (262) 646-2771
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DELAFIELD DENTAL SPECIALISTS LLC is a general practice dentist in Delafield, WI. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DELAFIELD DENTAL SPECIALISTS LLC NPI is 1407208002. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

920 INDIAN SPRING DR
DELAFIELD, WI
ZIP 53018-242
Phone: (262) 646-2771
Fax: (262) 646-2340

The provider's authorized official is Christopher Potrykus .
The authorized official title is Owner and has the following contact phone number (262) 646-2771.

The CLIA number assigned to this NPI record is 52D2083729 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2016 and was last updated on 7/7/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice6886WISCONSINYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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