Individual provider Active NPI

Nicolas Robert Branshaw, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Brookfield, WI
National Provider Identifier
1326597238
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
1001398 Issued in WI
Practice address
17135 W. Capitol Dr.
Suite 100
Brookfield, WI 53005-2193
Phone
(262) 200-9445
NPI assigned
Oct 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1001398 WI
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 1001398 WI Primary

Addresses

Primary practice location

17135 W. Capitol Dr.
Suite 100
Brookfield, WI 53005-2193

Mailing address

7117 Green Bay Rd
Kenosha, WI 53142-1450
Phone (715) 828-9655

Other practice location 1

10625 W North Ave
Milwaukee, WI 53226-2315
Phone (414) 774-5020

Other practice location 2

7117 Green Bay Rd
Kenosha, WI 53142-1450
Phone (715) 828-9655

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
I20180822000890 WI Order and Referring Only - DentistPractitioner - Dentist 3476802604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001398WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Branshaw Orthodontics, LLC Orthodontics and Dentofacial Orthopedics CurrentSince Aug 17, 2025 Accepting new patients

Locations

17135 W Capitol Dr
Ste 100
Brookfield, WI 53005
Phone (262) 200-9445

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1326597238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 GREEN BAY RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531421450",
            "telephone_number": "715-828-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17135 W. CAPITOL DR.",
            "address_2": "SUITE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530052193",
            "telephone_number": "262-200-9445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10625 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532262315",
            "country_code": "US",
            "telephone_number": "414-774-5020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7117 Green Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531421450",
            "country_code": "US",
            "telephone_number": "715-828-9655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANSHAW",
        "first_name": "NICOLAS",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-04",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001398",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "1001398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.