NPIMap

Organization Active NPI

Galleria West Dental S.C.

  • General Practice Dentistry
  • Brookfield, WI
National Provider Identifier
1386906410
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GALLERIA WEST DENTAL S.C.
Practice address
18900 W Bluemound Rd
Suite 218
Brookfield, WI 53045-6092
Phone
(262) 754-2727
Fax
(262) 789-6797
NPI assigned
Jun 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Authorized official

Name
Dr. Eric W Biederwolf, DDSNPI 1760894729
Title
Owner/Dentist/President
Phone
(262) 754-2727

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 DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

18900 W Bluemound Rd
Suite 218
Brookfield, WI 53045-6092

Mailing address

18900 W Bluemound Rd
Brookfield, WI 53045-6092
Phone (262) 754-2727

Other names 1

  • Galleria West Family Dental Other name

National Provider Directory

National Provider Directory

Locations

18900 W Bluemound Rd
Ste 218
Brookfield, WI 53045
Phone (262) 754-2727

18900 W Bluemound Rd
Brookfield, WI 53045

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1386906410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18900 W BLUEMOUND RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530456092",
            "telephone_number": "262-754-2727",
            "fax_number": "262-789-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18900 W BLUEMOUND RD",
            "address_2": "SUITE 218",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530456092",
            "telephone_number": "262-754-2727",
            "fax_number": "262-789-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALLERIA WEST DENTAL S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "BIEDERWOLF",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "262-754-2727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Galleria West Family Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.