Active NPI
Bryan Schwartz, D.D.S.
- General Practice Dentistry
- Pewaukee, WI
National Provider Identifier
1679694905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5513
- Practice address
- 125 W Wisconsin Ave
Suite 102
Pewaukee, WI 53072-3416 - Phone
- (262) 737-4004
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5513 | WI | Primary |
Addresses
Primary practice location
125 W Wisconsin Ave
Suite 102
Pewaukee, WI 53072-3416
Mailing address
125 W Wisconsin Ave
Suite 102
Pewaukee, WI 53072-3416
Phone (262) 737-4004
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5513 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bryan J Schwartz DDS, SC | Past | Accepting new patients | |
| Lake Geneva Dental Care LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Pewaukee, WI
- NPI 1598181141
-
- General Practice Dentistry
- Lake Geneva, WI
- NPI 1083732101
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458172800000",
"number": "1679694905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 W WISCONSIN AVE",
"address_2": "SUITE 102",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530723416",
"telephone_number": "262-737-4004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 W WISCONSIN AVE",
"address_2": "SUITE 102",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530723416",
"telephone_number": "262-737-4004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHWARTZ",
"first_name": "BRYAN",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2016-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "5513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pewaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.