PSP Health

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

PSP HEALTH

Practice address

1925 S Green Bay Rd
Mount Pleasant, WI 53406-4654

Phone

(262) 634-4646

Fax

(262) 634-4694

NPI assigned

Feb 8, 2021

Organization subpart

No

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

Authorized official

Name

Paul S Pamula, DDS MDNPI 1073930459

Title

Owner

Phone

(262) 634-4646

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Pamula

  • Oral and Maxillofacial Surgery (Dentist)
  • Mount Pleasant, WI
  • NPI 1073930459
  NPD Authorized official
• Richard M Wagner, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Racine, WI
  • NPI 1770700957
  NPD (past)

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1033701495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 S GREEN BAY RD",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534064654",
            "telephone_number": "262-634-4646",
            "fax_number": "262-634-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 S GREEN BAY RD",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534064654",
            "telephone_number": "262-634-4646",
            "fax_number": "262-634-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSP HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "PAMULA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-634-4646",
        "authorized_official_credential": "DDS MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Elizabeth Prater, ATR, LPC, CSAC
• Premier Radiology Wisconsin, LLC
• Branko Prpa, M.D.
• Nicholas Z Pryomski, M.D.
• Jason Henry Przybylo, MD
• PT Plus Management Corp
• Carolyn Lysa Ptaszek, OTR/L
• Praakrut Purohit, DMD
• Melissa Marie Pust, M.S. OTR/L
• Janis Putirskis, RN

• Oral and Maxillofacial Surgery (Dentist) in Mount Pleasant, WI
• Providers in Mount Pleasant, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.