NPIMap

Organization Active NPI

Elmbrook Family Dental, S.C.

  • General Practice Dentistry
  • Brookfield, WI
National Provider Identifier
1124075023
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5001902-015 Issued in WI
Legal business name
ELMBROOK FAMILY DENTAL, S.C.
Practice address
125 N Executive Dr
Suite 105
Brookfield, WI 53005-6070
Phone
(262) 784-7201
Fax
(262) 784-0542
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Authorized official

Name
Dr. William Brian Neuschaefer, DDSNPI 1013958107
Title
President
Phone
(262) 784-7201

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5001902-015 WI Primary

Addresses

Primary practice location

125 N Executive Dr
Suite 105
Brookfield, WI 53005-6070

Mailing address

125 N Executive Dr
Suite 105
Brookfield, WI 53005-6070
Phone (262) 784-7201

Other names 1

  • William Neuschaefer D.D.S., S. C. Former legal business name

National Provider Directory

National Provider Directory

Locations

125 N Executive Dr
Ste 105
Brookfield, WI 53005
Phone (262) 444-0232

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1124075023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N EXECUTIVE DR",
            "address_2": "SUITE 105",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056070",
            "telephone_number": "262-784-7201",
            "fax_number": "262-784-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N EXECUTIVE DR",
            "address_2": "SUITE 105",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056070",
            "telephone_number": "262-784-7201",
            "fax_number": "262-784-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMBROOK FAMILY DENTAL, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "NEUSCHAEFER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-784-7201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001902-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "William Neuschaefer D.D.S., S. C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.