NPIMap

Organization Active NPI

Wisconsin Dental Group,S.C.

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1467582833
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WISCONSIN DENTAL GROUP,S.C.
Practice address
9052 N Deerbrook TRL
Milwaukee, WI 53223-2474
Phone
(414) 357-2040
Fax
(414) 354-3177
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Peter Young
Title
VP
Phone
(414) 357-2040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

9052 N Deerbrook TRL
Milwaukee, WI 53223-2474

Mailing address

9052 N Deerbrook TRL
Milwaukee, WI 53223-2474
Phone (414) 357-2040

Other names 1

  • Forward Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wi DTL GRP-HLS CRNS32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467582833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9052 N DEERBROOK TRL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532232474",
            "telephone_number": "414-357-2040",
            "fax_number": "414-354-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9052 N DEERBROOK TRL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532232474",
            "telephone_number": "414-357-2040",
            "fax_number": "414-354-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN DENTAL GROUP,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "414-357-2040"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forward Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.