Milwaukee Dental Group SC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3107-15 Issued in WI

Legal business name

MILWAUKEE DENTAL GROUP SC

Practice address

5542 W Fond Du Lac Ave
Milwaukee, WI 53216-1200

Phone

(414) 378-7971

NPI assigned

Sep 7, 2016

Last updated

Sep 7, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sham ChandokNPI 1093974321

Title

Owner

Phone

(414) 378-7971

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sham S Chandok, DDS

  • General Practice Dentistry
  • Milwaukee, WI
  • NPI 1093974321
  Authorized official Same address or phone

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1457808487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5542 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161200",
            "telephone_number": "414-378-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5542 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161200",
            "telephone_number": "414-378-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILWAUKEE DENTAL GROUP SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "CHANDOK",
        "authorized_official_first_name": "SHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-378-7971",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3107-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milwaukee County Department of Health and Human Services
• Milwaukee County Department on Aging Care Management Organization
• Milwaukee County Mental Health Division
• Milwaukee County Oem-EMS (Milwaukee County Paramedic Program)
• Milwaukee Dental Arts LLC
• Milwaukee Digestive Disease Consultants, S.C.
• Milwaukee Ep, LLC
• Milwaukee Eye & Cataract Clinic S.C.
• Milwaukee Eye Care Associates S.C.
• Milwaukee Eye Care Associates S.C.

• General Practice Dentistry in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.