Active NPI
Robert William Meddaugh, D.D.S.
- General Practice Dentistry
- West Allis, WI
National Provider Identifier
1194739086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3215
- Practice address
- 2075 S 81St St
West Allis, WI 53219-1013 - Phone
- (414) 327-6160
- Fax
- (414) 327-6088
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3215 | WI | Primary |
Addresses
Primary practice location
2075 S 81St St
West Allis, WI 53219-1013
Mailing address
2075 S 81St St
West Allis, WI 53219-1013
Phone (414) 327-6160
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3215 | WI | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194739086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2075 S 81ST ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532191013",
"telephone_number": "414-327-6160",
"fax_number": "414-327-6088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2075 S 81ST ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532191013",
"telephone_number": "414-327-6160",
"fax_number": "414-327-6088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDDAUGH",
"first_name": "ROBERT",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "3215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Allis, WI
- Karen Elizabeth McNerney, FNP-BC
- MDS Digital Portable X-Ray Inc
- MDS Digital Portable X-Ray Inc
- MDS Digital Portable X-Ray Inc.
- Meadowmere and Mitchell Manor Senior Living
- Medical Equipment Specialists (Sleep Service Center)
- Medical Equipment Specialists Inc (Pulmedix)
- Medicalsupply LLC
- Anne F Mees, MSW, APSW
- Anjali Sudershan Krishan Mehta, DMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.