Provider Demographics
NPI:1215730627
Name:VIRTUE ORTHODONTICS LLC
Entity type:Organization
Organization Name:VIRTUE ORTHODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:262-200-9445
Mailing Address - Street 1:17135 W CAPTIOL DRIVE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005
Mailing Address - Country:US
Mailing Address - Phone:262-200-9445
Mailing Address - Fax:262-200-9721
Practice Address - Street 1:17135 W CAPTIOL DRIVE SUITE 100
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005
Practice Address - Country:US
Practice Address - Phone:262-200-9445
Practice Address - Fax:262-200-9721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty