Wisconsin Oral & Maxillofacial Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

WISCONSIN ORAL & MAXILLOFACIAL SURGERY LLC

Doing business as

White Oak Dental

Practice address

2603 W Rawson Ave Ste 123
Oak Creek, WI 53154-8422

Phone

(914) 325-5672

NPI assigned

Jun 5, 2018

Last updated

Jun 5, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ejlal Alalawi, DMDNPI 1356645634

Title

Owner/Provider

Phone

(914) 325-5672

Specialties & licenses 2

Addresses

Other names 1

• White Oak Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ejlal Alalawi, D.M.D.

  • Dentist
  • New Berlin, WI
  • NPI 1356645634
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528156800000",
    "number": "1013409002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 LEGEND WAY",
            "city": "WALES",
            "state": "WI",
            "postal_code": "531839539",
            "telephone_number": "914-325-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 W RAWSON AVE STE 123",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531548422",
            "telephone_number": "914-325-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN ORAL & MAXILLOFACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A",
        "authorized_official_last_name": "ALALAWI",
        "authorized_official_first_name": "EJLAL",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "914-325-5672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Oak Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tammy Ann Wilson, RN
• Wisconsin CVS Pharmacy LLC (CVS Pharmacy #17043)
• Wisconsin Dental Group, S.C. (ForwardDental Oak Creek)
• Wisconsin Lutheran Child & Family Service, Inc (Christian Family Counseling)
• Wisconsin Neurology Clinic, LLC
• Wisconsin Orthotics & Prosthetics Center LLC
• Stephanie Lynn Witt
• Catherine Ann Woehlck, LPC
• Lisa Wolf, MD
• Joseph M Wolfe, MD

• Oral and Maxillofacial Surgery Clinic/Center in Oak Creek, WI
• Providers in Oak Creek, WI by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.