NPIMap

Organization Active NPI

Elmbrook Family Dental Partners SC

  • General Practice Dentistry
  • Brookfield, WI
National Provider Identifier
1134448632
Registry record updated May 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5526-015 Issued in WI
Legal business name
ELMBROOK FAMILY DENTAL PARTNERS SC
Practice address
125 N Executive Dr
Suite 105
Brookfield, WI 53005-6070
Phone
(262) 784-7201
Fax
(262) 784-0542
NPI assigned
May 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2010

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

Authorized official

Name
Dr. Brandon Andrew Brunner, D.D.S.NPI 1801838875
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: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 5526-015 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

  • ELMBROOK FAMILY DENTAL Doing business as

National Provider Directory

National Provider Directory

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": "1274659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274659200000",
    "number": "1134448632",
    "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 PARTNERS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-24",
        "last_updated": "2010-05-24",
        "status": "A",
        "authorized_official_last_name": "BRUNNER",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-784-7201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5526-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELMBROOK FAMILY DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 24, 2010; 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.