Oconomowoc Dental Anesthesia Center

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

OCONOMOWOC DENTAL ANESTHESIA CENTER

Practice address

888 Thackeray TRL Ste 214
Oconomowoc, WI 53066-4342

Phone

(262) 567-9116

NPI assigned

Jun 25, 2019

Last updated

Jun 25, 2019By 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

Henry Hopkinson

Title

Executive Director

Phone

(321) 514-4992

Specialties & licenses 1

Addresses

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.

• Jose Antonio Gonzalez, DDS

  • General Practice Dentistry
  • Oconomowoc, WI
  • NPI 1508430091
  NPD (past)

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1053972661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 THACKERAY TRL STE 214",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664342",
            "telephone_number": "262-567-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 THACKERAY TRL STE 214",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664342",
            "telephone_number": "262-567-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCONOMOWOC DENTAL ANESTHESIA CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "HOPKINSON",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "321-514-4992"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick O'Malley, D.O.
• Oaac, S.C.
• Oconomowoc Area School District
• Oconomowoc Chiropractic
• Oconomowoc Community Services LLC
• Oconomowoc Development Training Center LL
• Oconomowoc Developmental Training Center of Wisconsin LLC
• Oconomowoc Developmental Training Center of Wisconsin LLC (Oconomowoc Developmental Training Center ODTC)
• Oconomowoc Home Health Care, LLC
• Oconomowoc Vision Clinic, LLC

• Oral and Maxillofacial Surgery Clinic/Center in Oconomowoc, WI
• Providers in Oconomowoc, 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 25, 2019; 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.