Individual provider Active NPI

Neal Rosenberg III, D.D.S

  • Dentist
  • Cedarburg, WI
National Provider Identifier
1447659644
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1000990-015 Issued in WI
Practice address
N57W6296 Center St
Cedarburg, WI 53012-1906
Phone
(262) 377-5130
NPI assigned
Aug 14, 2014
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1000990-15 WI
Dentist 122300000X 1000990-015 WI Primary

Addresses

Primary practice location

N57W6296 Center St
Cedarburg, WI 53012-1906

Mailing address

746 Lakefield Rd
Grafton, WI 53024-9722
Phone (262) 707-2931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160108001887 WI Order and Referring Only - DentistPractitioner - Dentist 6305148271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1000990-015WIMDDentist
1000990-15WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahp 005 LLC CurrentSince Feb 2, 2025 Accepting new patients

Locations

N57W6296 Center St
Cedarburg, WI 53012
Phone (262) 377-5130

Interoperability endpoints

  • Direct secure messaging: nrosenberg364201@direct.ochin.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1447659644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 LAKEFIELD RD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249722",
            "telephone_number": "262-707-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N57W6296 CENTER ST",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530121906",
            "telephone_number": "262-377-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "NEAL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-14",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1000990-15",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1000990-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarburg, WI

Sources for this page

Verify at the official NPI Registry.