Wisconsin Oral Medicine LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

WISCONSIN ORAL MEDICINE LLC

Practice address

8405 W Forest Home Ave
Greenfield, WI 53228-3407

Phone

(443) 255-8743

NPI assigned

May 23, 2025

Organization subpart

No

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

Authorized official

Name

Bhavik Desai, MDNPI 1790003440

Title

Owner

Phone

(443) 255-8743

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 1

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

• Bhavik S. Desai, DMD, PHD

  • Oral and Maxillofacial Surgery (Dentist)
  • Greenfield, WI
  • NPI 1790003440
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1417740465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-858-4125",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8405 W FOREST HOME AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283407",
            "telephone_number": "443-255-8743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN ORAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "BHAVIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-255-8743",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Wirtz
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• Wisconsin Center for Neurological Disorders, S.C.
• Wisconsin Health Center
• Wisconsin Health Center LLC
• Wisconsin Vision, LLC
• Meghan R Wisneski, AUD.
• Brian Scott Wisniewski, BC-HIS
• Jordan Scott Wisniewski, HIS
• Marybeth Wisniewski, APRN-BC, FNP

• Oral and Maxillofacial Surgery (Dentist) in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.