Individual provider Active NPI

William R. Conner, D.D.S.

  • Dentist
  • Wauwatosa, WI
National Provider Identifier
1669690509
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5002033 Issued in WI
Practice address
11407 W. Bluemound Rd.
Wauwatosa, WI 53226
Phone
(414) 258-0120
Fax
(414) 259-9850
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5002033 WI Primary

Addresses

Primary practice location

11407 W. Bluemound Rd.
Wauwatosa, WI 53226

Mailing address

11407 W. Bluemound Rd.
Wauwatosa, WI 53226
Phone (414) 258-0120

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

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1669690509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11407 W. BLUEMOUND RD.",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-258-0120",
            "fax_number": "414-259-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11407 W. BLUEMOUND RD.",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-258-0120",
            "fax_number": "414-259-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "WILLIAM",
        "middle_name": "R.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5002033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.