Active NPI
Kenneth James Zganjar, DDS
- General Practice Dentistry
- Brown Deer, WI
National Provider Identifier
1457463986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5001826
- Practice address
- 6051 W Brown Deer Rd
Suite 201
Brown Deer, WI 53223-2263 - Phone
- (414) 355-3202
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5001826 | WI | Primary |
Addresses
Primary practice location
6051 W Brown Deer Rd
Suite 201
Brown Deer, WI 53223-2263
Mailing address
6051 W Brown Deer Rd
Suite 201
Brown Deer, WI 53223-2263
Phone (414) 355-3202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5001826 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457463986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6051 W BROWN DEER RD",
"address_2": "SUITE 201",
"city": "BROWN DEER",
"state": "WI",
"postal_code": "532232263",
"telephone_number": "414-355-3202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6051 W BROWN DEER RD",
"address_2": "SUITE 201",
"city": "BROWN DEER",
"state": "WI",
"postal_code": "532232263",
"telephone_number": "414-355-3202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZGANJAR",
"first_name": "KENNETH",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "5001826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brown Deer, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.