Nicholas Dwan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1001083-15 Issued in WI

Practice address

3333 S Sunnyslope Rd Ste 100
New Berlin, WI 53151-4504

Phone

(262) 505-1000

NPI assigned

Apr 29, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Willow Dental Group LLC

  • Dental Clinic/Center
  • New Berlin, WI
  • NPI 1609493188
  NPD Authorized official
• Charles C. Anderson D.D.S. S.C.

  • General Practice Dentistry
  • Franklin, WI
  • NPI 1467729020
  NPD (past)
• Robert J. Schweitzer D.D.S.,S.C.

  • General Practice Dentistry
  • Franklin, WI
  • NPI 1063574002
  NPD (past)

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1255718169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 S SUNNYSLOPE RD STE 100",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514504",
            "telephone_number": "262-505-1000",
            "fax_number": "262-505-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S SUNNYSLOPE RD STE 100",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514504",
            "telephone_number": "262-505-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWAN",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-29",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001083-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura S Duncan, MD
• Adane Durham, DPT
• Durski Chiropractic
• Jeff Durski, D.O.
• Joanne S Dustrude, RN
• John W Dykstra, H.I.S.
• Jacqueline K Edwards, PA-C
• Linda Marie Eichenberger
• Andrew Eichholz, DDS
• Dina Elbatiti, RPH

• General Practice Dentistry in New Berlin, WI
• Providers in New Berlin, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.