Individual provider Active NPI

Christy Anna Gajewski, D.D.S.

  • General Practice Dentistry
  • Pewaukee, WI
National Provider Identifier
1184672065
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5500-015 Issued in WI
Practice address
2305 Silvernail Rd
Pewaukee, WI 53072-5402
Phone
(262) 548-0770
NPI assigned
May 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5500-015 WI Primary

Addresses

Primary practice location

2305 Silvernail Rd
Pewaukee, WI 53072-5402

Mailing address

N5037 Wilderness Shore LN
Irma, WI 54442-9648
Phone (715) 536-1977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160523001789 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9032408588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5500-015WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184672065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N5037 WILDERNESS SHORE LN",
            "city": "IRMA",
            "state": "WI",
            "postal_code": "544429648",
            "telephone_number": "715-536-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 SILVERNAIL RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530725402",
            "telephone_number": "262-548-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJEWSKI",
        "first_name": "CHRISTY",
        "middle_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5500-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

Verify at the official NPI Registry.