Individual provider Active NPI

Anshul Mahajan, D.D.S

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1336827559
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6001251 Issued in WI
Practice address
142 E Capitol Dr
Milwaukee, WI 53212-1206
Phone
(414) 444-1823
NPI assigned
Jul 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6001251 WI Primary

Addresses

Primary practice location

142 E Capitol Dr
Milwaukee, WI 53212-1206

Mailing address

280 N Market St Unit 414
Brookfield, WI 53045-3245
Phone (215) 908-1355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6001251WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Familia Dental River Glen LLC CurrentSince Jul 9, 2023 Accepting new patients
Familia Dental River Glen LLC CurrentSince Jul 9, 2023 Accepting new patients
The Richford Health Center Inc Past Accepting new patients

Locations

142 E Capitol Dr
Milwaukee, WI 53212
Phone (414) 444-1823

Organizations & group practices 3

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": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1336827559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 N MARKET ST UNIT 414",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530453245",
            "telephone_number": "215-908-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 E CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121206",
            "telephone_number": "414-444-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAJAN",
        "first_name": "ANSHUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.