NPIMap

Organization Active NPI

Parkway Dental, S.C.

  • General Practice Dentistry
  • Milwaukee, WI
National Provider Identifier
1578856225
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5001656 Issued in WI
Legal business name
PARKWAY DENTAL, S.C.
Practice address
2901 W Kinnickinnic River Pkwy Ste 104
Milwaukee, WI 53215-3660
Phone
(414) 649-3510
Fax
(414) 385-2854
NPI assigned
May 26, 2011
Last updated
May 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2011

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

Authorized official

Name
Thomas E Kielma, D.D.S.NPI 1982763983
Title
Owner
Phone
(414) 649-3510

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 5001656 WI Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 5003 WI

Addresses

Primary practice location

2901 W Kinnickinnic River Pkwy Ste 104
Milwaukee, WI 53215-3660

Mailing address

2901 W Kinnickinnic River Pkwy Ste 104
Milwaukee, WI 53215-3660
Phone (414) 649-3510

National Provider Directory

National Provider Directory

Locations

2901 W Kinnickinnic River Pkwy
Ste 104
Milwaukee, WI 53215
Phone (414) 649-3510

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1578856225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY STE 104",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660",
            "telephone_number": "414-649-3510",
            "fax_number": "414-385-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY STE 104",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660",
            "telephone_number": "414-649-3510",
            "fax_number": "414-385-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY DENTAL, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "KIELMA",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-649-3510",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001656",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5003",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 26, 2011; 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.