Progressive Pediatric Dentist SC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

4919 Issued in WI

Legal business name

PROGRESSIVE PEDIATRIC DENTIST SC

Practice address

8375 S Howell Ave
#201
Oak Creek, WI 53154-8344

Phone

(414) 768-1020

Fax

(414) 768-8866

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Steven Robert ChybowskiNPI 1063418416

Title

Dentist

Phone

(414) 768-1020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Steven Chybowski Former legal business name

Locations

Practitioners 1

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

• Steven R Chybowski, DDS

  • Pediatric Dentistry
  • Oak Creek, WI
  • NPI 1063418416
  NPD (past) Authorized official

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268179200000",
    "number": "1174638142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8375 S HOWELL AVE",
            "address_2": "#201",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531548344",
            "telephone_number": "414-768-1020",
            "fax_number": "414-768-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8375 S HOWELL AVE",
            "address_2": "#201",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531548344",
            "telephone_number": "414-768-1020",
            "fax_number": "414-768-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PEDIATRIC DENTIST SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-03-10",
        "status": "A",
        "authorized_official_last_name": "CHYBOWSKI",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "414-768-1020",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "4919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38393100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Steven Chybowski",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Physiotherapy Associates Inc
• Leslie E Pierce, PA-C
• Sarah E Pierce, M.D.
• Katie Pogodzinski
• Jennifer L Pozorski, MSW, LCSW,CSAC
• Agnes Prospere, MD
• Julie Pulley, RN
• Kayla Pulley
• Purerfid, Inc.
• Nabila Quadri, M.D.

• All providers in Oak Creek, WI
• Pediatric Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.