Individual provider Active NPI

James Dominick Dolan, MD

  • Obstetrics & Gynecology Physician
  • West Allis, WI
National Provider Identifier
1639270796
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20460-020 Issued in WI
Practice address
8905 W Lincoln Ave
Suite 515
West Allis, WI 53227-2468
Phone
(414) 328-8650
Fax
(414) 328-8660
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 20460-020 WI Primary

Addresses

Primary practice location

8905 W Lincoln Ave
Suite 515
West Allis, WI 53227-2468

Mailing address

8905 W Lincoln Ave
Suite 515
West Allis, WI 53227-2468
Phone (414) 328-8650

Other identifiers 1

IdentifierTypeStateIssuer
30299200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20460-020WIMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1639270796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8905 W LINCOLN AVE",
            "address_2": "SUITE 515",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272468",
            "telephone_number": "414-328-8650",
            "fax_number": "414-328-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8905 W LINCOLN AVE",
            "address_2": "SUITE 515",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272468",
            "telephone_number": "414-328-8650",
            "fax_number": "414-328-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "JAMES",
        "middle_name": "DOMINICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "20460-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30299200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.