Mohamed Z Adl, DDS
Individual provider Active NPI General Practice Dentistry · West Allis, WI
NPI 1083640460 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1083640460
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5527-015 (WI)
- Practice address
- 555 S 108TH St
West Allis, WI 53214-1100 - Phone
- (414) 566-6400
- Fax
- (414) 566-3900
- NPI assigned
- Jun 25, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160520000340 | WI | Order and Referring Only - Dentist |
9537458179 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5527-015 | WI | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5527-015 | WI | Yes |
Addresses
Primary practice location
555 S 108TH St
West Allis, WI 53214-1100
Mailing address
555 S 108TH St
West Allis, WI 53214-1100
Phone (414) 566-6400
Other providers in West Allis, WI
- Alan David Adams
- Albert Henry Adams
- Inez Adams
- Addiction Services and Pharmacotherapy, SC
- Adekunle Adesokan
- Adore Home Health LLC
- Advanced Dental
- Advancing Abilities of Wisconsin
- Advancing Abilities of Wisconsin, LLC
- Aegis Group Practice LLC
All providers in West Allis, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.