ORCHARD DENTAL SC (NPI# 1316335763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316335763 |
| Entity Type | Organization |
| Organization Name | ORCHARD DENTAL SC |
| Other Organization Name | WISCONSIN SMILES |
| Practice Address |
1469 S 70th St West Allis WI 53214-4814 |
| Practice Telephone | 4143835833 |
| Practice Fax Number | 4143830233 |
| Mailing Telephone | 4143835833 |
| Mailing Fax Number | 4143830233 |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2015-01-07 |
| Authorized Official Name | DR. ROBERTO EDGARDO MONTEAGUDO (OWNER) |
| Authorized Official Telephone | 4143835833 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
4186 | WI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| WISCONSIN SMILES | Doing Business As Name - Organization |
| Street Address |
1469 S 70TH ST |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53214-4814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750507356 | Roberto Edgardo Monteagudo | Dentist | 1469 S 70th St, West Allis, WI 53214-4814 | 2007-04-18 |
| 1811425408 | Silvia Bautista Morrobel | Dentist | 1469 S 70th St, West Allis, WI 53214-4814 | 2017-05-26 |
| 1295185981 | Emergency Dental of Milwaukee, LLC | Dentist | 1469 S 70th St, West Allis, WI 53214-4814 | 2016-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740740208 | Melanie Figueroa | Counselor | West Milwaukee Ctc, 1610 Miller Park Way, West Milwaukee, WI 53214 | 2019-03-21 |
| 1619403011 | Lea Salome Denny | Counselor | 8626b W Greenfield Ave, Suite B300, West Allis, WI 53214 | 2017-05-04 |
| 1891148318 | West Allis Prescription Center Inc | Pharmacy | 6737 W Washington Ave, Suite 1100, West Allis, WI 53214 | 2016-07-20 |
| 1316390495 | Kristina Overlee | Nurse Practitioner | 6737 W. Washington Street, Suite 2150, West Allis, WI 53214 | 2016-07-13 |
| 1801239843 | Daniel Anthony Cichy | Pharmacist | 10101 W Greenfield Ave Ste 130, West Allis, WI 53214 | 2013-04-09 |
| 1295072544 | Wisconsin Vision, Inc. | Optometrist | 1220 Miller Park Way, West Milwaukee, WI 53214 | 2013-01-07 |
| 1831457720 | Kevin Konieczka | Physical Therapist | 1224 Miller Parkway, Milwaukee, WI 53214 | 2012-04-27 |
| 1497031843 | Jill Elizabeth Gerou | Registered Nurse | 8420 West Greenfield Ave, Apartment #7, West Allis, WI 53214 | 2011-10-31 |
| 1700176815 | Carolyn Hasek | Counselor | 1126 S 70th St Ste 112-113, West Allis, WI 53214 | 2011-04-10 |
| 1972802775 | Barbara Smith | Licensed Practical Nurse | 651 S 63 St, Apt1, Milwaukee, WI 53214 | 2011-03-18 |
| Find all providers in zip 53214 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871118554 | Third Coast Dental LLC | Clinic/Center | 8531 W Lincoln Ave, West Allis, WI 53227-2542 | 2020-06-09 |
| 1588297584 | Keystone West Allis LLC West Allis Dental Care | Clinic/Center | 7130 W Greenfield Ave, West Allis, WI 53214-4708 | 2020-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063907 | Osceola Family Dental, Ltd | Clinic/Center | 215 N Cascade St, Osceola, WI 54020 | 2020-11-03 |
| 1578173985 | Bright Dental and Braces LLC | Clinic/Center | 3046 Fish Hatchery Rd, Fitchburg, WI 53713-3125 | 2020-08-01 |
| 1609493188 | Willow Dental Group LLC | Clinic/Center | 3333 S Sunnyslope Rd Ste 100, New Berlin, WI 53151-4504 | 2020-06-30 |
| 1447875711 | Iola Family Dental, LLC | Clinic/Center | 100 Pine Crest Ln, Iola, WI 54945-8230 | 2020-06-12 |
| 1073135331 | Oasis Dental LLC | Clinic/Center | 1037 S Cesar E Chavez Dr, Milwaukee, WI 53204-2204 | 2020-05-09 |
| 1679116685 | Mdc Milwaukee, LLC | Clinic/Center | 4701 W National Ave, Milwaukee, WI 53214-3521 | 2019-10-22 |
| 1982263893 | Schmidt Dental Holdings LLC | Clinic/Center | 7430 W Forest Home Ave, Greenfield, WI 53220-3358 | 2019-06-13 |
| 1124580352 | Upper Lakes Dental, LLC | Clinic/Center | 908 E Main St Ste C, Winneconne, WI 54986-9672 | 2019-04-05 |
| 1356808067 | Julia Fosterarmstrong | Clinic/Center | 335 Vernal Ave, Milton, WI 53563-1248 | 2019-02-28 |
| 1366907032 | Dr John M Kane Sc | Clinic/Center | 10317 N Greenwood Ln, Hayward, WI 54843-7167 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
| City | WEST ALLIS |
| Zip Code | 53214 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.