Gregory A Nyffeler, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

3697 Issued in WI

Practice address

2481 Executive Dr
East Troy, WI 53120

Phone

(262) 642-5695

Fax

(262) 642-5395

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East Troy Family Dental Center SC

  • Dental Clinic/Center
  • East Troy, WI
  • NPI 1376607408
  NPD (past) Authorized official
• Behrend Family Dentistry and Associates, S.C.

  • General Practice Dentistry
  • East Troy, WI
  • NPI 1346071859
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063554350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 642",
            "address_2": "2481 EXECUTIVE DR",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "53120",
            "telephone_number": "262-642-5695",
            "fax_number": "262-642-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2481 EXECUTIVE DR",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "53120",
            "telephone_number": "262-642-5695",
            "fax_number": "262-642-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYFFELER",
        "first_name": "GREGORY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "3697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33489700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "391449280018",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie A. Mroch, RN
• Janell Murguia
• Parker Nimmer, DPT
• No Place Like Home Health Care LLC
• Briana Noel, DPT
• Tracy Ojeda, M.S. ED
• Koren Pehkonen
• Trisha M Peterson, PTA
• Jessica D Prohuska, L.AC
• Neil James Rennick, DO

• Dentist in East Troy, WI
• Providers in East Troy, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.