{"npi":"1417740465","type":"NPI-2","status":"active","name":{"display":"Wisconsin Oral Medicine LLC","other":[],"organization_name":"WISCONSIN ORAL MEDICINE LLC","authorised_official":"Bhavik Desai"},"specialty":{"primary_taxonomy":"1223S0112X","primary_taxonomy_description":"Oral and Maxillofacial Surgery (Dentist)","slug":"oral-and-maxillofacial-surgery-dentist","schema_org_specialty":null,"all":[{"code":"1223S0112X","description":"Oral and Maxillofacial Surgery (Dentist)","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"8405 W FOREST HOME AVE","city":"GREENFIELD","state":"WI","postal_code":"532283407","country_code":"US","phone":"4432558743"},{"purpose":"MAILING","street_1":"6400 INDUSTRIAL LOOP","city":"GREENDALE","state":"WI","postal_code":"531292452","country_code":"US","phone":"4148584125","fax":"4144234134"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20250815001184","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"WI","pac_id":"0345749552"}]},"enumeration_date":"2025-05-23","last_updated":"2025-05-23","_meta":{"source":"NPPES","snapshot_date":"2025-05-23","doc_url":"https://findmynpi.com/api"}}