Shorewood Family Dentistry, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SHOREWOOD FAMILY DENTISTRY, LLC

Practice address

3970 N Oakland Ave Ste 702
Shorewood, WI 53211-2265

Phone

(414) 332-8150

Fax

(414) 332-6202

NPI assigned

Oct 23, 2021

Last updated

Oct 23, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Peter James Colosimo, DDSNPI 1679987838

Title

Owner Member Dentist

Phone

(414) 526-3271

Specialties & licenses 1

Addresses

Other names 1

• Peter P Colosimo, DDS, SC Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter James Colosimo, D.D.S.

  • General Practice Dentistry
  • Shorewood, WI
  • NPI 1679987838
  NPD Authorized official
• Peter P Colosimo, DDS

  • Dentist
  • Shorewood, WI
  • NPI 1952521098
  NPD (past)

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

{
    "created_epoch": "1634947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634947200000",
    "number": "1336803600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 N OAKLAND AVE STE 702",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112265",
            "telephone_number": "414-332-8150",
            "fax_number": "414-332-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 N OAKLAND AVE STE 702",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112265",
            "telephone_number": "414-332-8150",
            "fax_number": "414-332-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOREWOOD FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-23",
        "last_updated": "2021-10-23",
        "certification_date": "2021-10-23",
        "status": "A",
        "authorized_official_last_name": "COLOSIMO",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER MEMBER DENTIST",
        "authorized_official_telephone_number": "414-526-3271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peter P Colosimo, DDS, SC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sage Specialty Pharmacy Inc.
• Deborah K Schermer, MS, CCC-SLP
• Mazen Seddick, RPH
• Judith Y Selby, RN
• Stephen Michael Sherman, D.C.
• Shorewood Family Physicians S C
• Shorewood Health Department
• Shorewood School District
• Shorewood Specialty LLC (Sage Specialty Pharmacy)
• Andrew M Silverman, LCSW

• General Practice Dentistry in Shorewood, WI
• Providers in Shorewood, 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 Oct 23, 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.