NPIMap

Organization Active NPI

Ridgeview Dental Group SC

  • General Practice Dentistry
  • Menomonee Falls, WI
National Provider Identifier
1437236536
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5334015 Issued in WI
Legal business name
RIDGEVIEW DENTAL GROUP SC
Practice address
W178 N9201 Water Tower Place
Suite 100
Menomonee Falls, WI 53051
Phone
(262) 251-8704
Fax
(262) 251-8341
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Authorized official

Name
Dr. Matthew Thomas Pruhs, DDSNPI 1114042330
Title
Owner/Partner
Phone
(262) 251-5355

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 0004063 WI
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 5334015 WI Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

W178 N9201 Water Tower Place
Suite 100
Menomonee Falls, WI 53051

Mailing address

W178 N9201 Water Tower Place
Suite 100
Menomonee Falls, WI 53051
Phone (262) 251-8704

National Provider Directory

National Provider Directory

Locations

W178N9201 Water Tower Pl
Ste 100
Menomonee Fls, WI 53051
Phone (262) 251-1173

Practitioners & affiliated clinicians

Practitioners 7

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1437236536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W178 N9201 WATER TOWER PLACE",
            "address_2": "SUITE 100",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "53051",
            "telephone_number": "262-251-8704",
            "fax_number": "262-251-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W178 N9201 WATER TOWER PLACE",
            "address_2": "SUITE 100",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "53051",
            "telephone_number": "262-251-8704",
            "fax_number": "262-251-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEVIEW DENTAL GROUP SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "PRUHS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "262-251-5355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "0004063",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5334015",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.