Bret Waligora, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

1001147 Issued in WI

Practice address

840 N 87TH St
Oral and Maxillofacial Surgery
Milwaukee, WI 53226-3586

Phone

(414) 805-5781

Fax

(414) 259-9115

NPI assigned

Jun 2, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 22, 2020 through Jul 22, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Milwaukee Oral Surgery & Implants LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Milwaukee, WI
  • NPI 1972550234
  NPD (past)

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1467832782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 N 87TH ST",
            "address_2": "ORAL AND MAXILLOFACIAL SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263586",
            "telephone_number": "414-805-5781",
            "fax_number": "414-259-9115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N 87TH ST",
            "address_2": "ORAL AND MAXILLOFACIAL SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263586",
            "telephone_number": "414-805-5781",
            "fax_number": "414-259-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALIGORA",
        "first_name": "BRET",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021509",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "1001147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #07370)
• Walgreen Co (Walgreens #02911)
• Walgreen Co. (Walgreens #07809)
• Walgreens
• Cassandra Lynn Sova Walia, MS, RD, CD
• Veronica Walinski
• Silvya Yomari Walker Pache, PHARMD
• Sheena Walker-Gardner
• Cheryl Walker-Lloyd, MSW
• Alicia N. Walker, PHARMD, RPH

• Oral and Maxillofacial Surgery (Dentist) in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.