Individual provider Active NPI

Maryam Tunio, DDS

  • General Practice Dentistry
  • Glendale, WI
National Provider Identifier
1114646072
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6001072-15 Issued in WI
Practice address
5623 N Green Bay Ave
Glendale, WI 53209-4406
Phone
(414) 228-3000
NPI assigned
Aug 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6001072-15 WI Primary

Addresses

Primary practice location

5623 N Green Bay Ave
Glendale, WI 53209-4406

Mailing address

9000 W Wisconsin Ave Ste 310
Milwaukee, WI 53226-4874
Phone (414) 266-2040

Other practice location 1

5433 W Fond Du Lac Ave
Milwaukee, WI 53216-1382
Phone (414) 445-6500

Other identifiers 1

IdentifierTypeStateIssuer
1114646072OtherNPI

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6001072-15WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Medical Group Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mtunio121363@direct.chw.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1114646072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE STE 310",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5623 N GREEN BAY AVE",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532094406",
            "telephone_number": "414-228-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5433 W Fond Du Lac Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532161382",
            "country_code": "US",
            "telephone_number": "414-445-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUNIO",
        "first_name": "MARYAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001072-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1114646072",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.