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JANESVILLE ENDODONTICS NPI 1891319273


NPI Information

NPI: 1891319273
Provider Name: JANESVILLE ENDODONTICS
Classification: Dentist - 1223E0200X
Entity Type: Organization

Specialization: Endodontics

CLIA Number: 52D0683049

Address:
1616 N RANDALL AVE STE 180
JANESVILLE, WI
ZIP 53545
Phone: (608) 314-9000
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JANESVILLE ENDODONTICS is an endodontics dentist in Janesville, WI. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. JANESVILLE ENDODONTICS NPI is 1891319273. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1616 N RANDALL AVE STE 180
JANESVILLE, WI
ZIP 53545-155
Phone: (608) 314-9000
Fax: (608) 314-3241

The provider's authorized official is Sofya Sulim .
The authorized official title is Office Administrator and has the following contact phone number (414) 520-2228.

The CLIA number assigned to this NPI record is 52D0683049 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/2/2020 and was last updated on 6/2/2020.


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
11223E0200XDentistEndodonticsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11001926OTHERWISCONSINSTATE LICENSE
21316415086OTHERWISCONSINNPI NUMBER

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.