NPIMap

Organization Active NPI

Sheild Family Dentistry, S.C.

  • General Practice Dentistry
  • Oconomowoc, WI
National Provider Identifier
1346460649
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3477 Issued in WI
Legal business name
SHEILD FAMILY DENTISTRY, S.C.
Practice address
1300 Summit Ave
Suite 101
Oconomowoc, WI 53066
Phone
(262) 567-1323
Fax
(262) 567-3422
NPI assigned
Apr 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Peter J Sheild, D.D.S.NPI 1386863355
Title
President
Phone
(262) 567-1323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3477 WI Primary

Addresses

Primary practice location

1300 Summit Ave
Suite 101
Oconomowoc, WI 53066

Mailing address

1300 Summit Ave
Suite 101
Oconomowoc, WI 53066
Phone (262) 567-1323

National Provider Directory

National Provider Directory

Locations

1300 N Summit Ave
Ste 101
Oconomowoc, WI 53066
Phone (262) 567-1323

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346460649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SUMMIT AVE",
            "address_2": "SUITE 101",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "53066",
            "telephone_number": "262-567-1323",
            "fax_number": "262-567-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SUMMIT AVE",
            "address_2": "SUITE 101",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "53066",
            "telephone_number": "262-567-1323",
            "fax_number": "262-567-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEILD FAMILY DENTISTRY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHEILD",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-567-1323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.