Individual provider Active NPI

Ujjwal Prasenjit Dutta, MD

  • Family Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1104734409
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
102184851 Issued in WI
Practice address
8701 Watertown Plank Rd
Milwaukee, WI 53226-3548
Phone
(414) 502-1818
NPI assigned
Aug 28, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 102184851 WI Primary

Addresses

Primary practice location

8701 Watertown Plank Rd
Milwaukee, WI 53226-3548

Mailing address

7300 W State St
Milwaukee, WI 53213-2768

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1104734409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 W STATE ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532132768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 WATERTOWN PLANK RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263548",
            "telephone_number": "414-502-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTA",
        "first_name": "UJJWAL",
        "middle_name": "PRASENJIT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-28",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "102184851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.