BRAD WISOWATY DDS LLC NPI 1609565910

NPI Information

  • NPI: 1609565910
  • Provider Name: BRAD WISOWATY DDS LLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 1302 VALE PARK RD
    VALPARAISO, IN
    ZIP 46383
  • Phone: (219) 462-0780

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NPI Details

BRAD WISOWATY DDS LLC is a dental clinic center in Valparaiso, IN. BRAD WISOWATY DDS LLC NPI is 1609565910. The provider is registered as an organization entity type.

The provider's business location address is:

1302 VALE PARK RD
VALPARAISO, IN
ZIP 46383-722
Phone: (219) 462-0780

The provider's authorized official is Brad Wisowaty .
The authorized official title is Member and has the following contact phone number (708) 945-5405.

The enumeration date for this NPI number is 5/3/2023 and was last updated on 5/3/2023.

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
1261QD0000XClinic/CenterDentalYes

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: 3/30/2025

NPI Synchronization or Removal

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