Greendale Dental Associates, S.C.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GREENDALE DENTAL ASSOCIATES, S.C.

Practice address

220A E Commerce CT
Elkhorn, WI 53121-4371

Phone

(262) 723-3224

Fax

(262) 723-2954

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert William Anderson, D.D.S.

Title

Secretary

Phone

(414) 421-2303

Specialties & licenses 1

Addresses

Tax ID family

Greendale Dental Associates SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Greendale Dental Associates, S.C.

  • Dentist
  • Greendale, WI
  • NPI 1659425163
  NPD tax ID

Locations

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093869109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5808 BROAD ST",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292404",
            "telephone_number": "414-421-2303",
            "fax_number": "414-421-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220A E COMMERCE CT",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214371",
            "telephone_number": "262-723-3224",
            "fax_number": "262-723-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENDALE DENTAL ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "414-421-2303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorelei E Glas
• Robin Lee Gosh, LPN
• Marc Elliott Gosnell, MD
• Nakash Grant, MD
• Ellen Green, CADC III, CCS
• Sheri H Grev ER-Skomski, SAC
• Chad Michael Greving, D.D.S
• Erica Jean Griffin, PT
• Catherine L Griffith, SAC
• Carolyn A Gualdron, PT

• Dentist in Elkhorn, WI
• Providers in Elkhorn, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.