NPIMap

Organization Active NPI

Highland Park Family Dentistry, SC

  • Dental Clinic/Center
  • Wauwatosa, WI
National Provider Identifier
1700131935
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
4097 Issued in WI
Legal business name
HIGHLAND PARK FAMILY DENTISTRY, SC
Practice address
6101 W Vliet St
Wauwatosa, WI 53213-2485
Phone
(414) 475-9035
Fax
(414) 475-9039
NPI assigned
Jul 13, 2012
Last updated
Jul 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Authorized official

Name
Dr. Robin Ann Gorman, DDSNPI 1316004864
Title
Owner
Phone
(414) 475-9035

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 4097 WI Primary

Addresses

Primary practice location

6101 W Vliet St
Wauwatosa, WI 53213-2485

Mailing address

6101 W Vliet St
Wauwatosa, WI 53213-2485
Phone (414) 475-9035

National Provider Directory

National Provider Directory

Locations

6101 W Vliet St
Wauwatosa, WI 53213
Phone (414) 475-9035

Practitioners & affiliated clinicians

Practitioners 3

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": "1342137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1700131935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 W VLIET ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132485",
            "telephone_number": "414-475-9035",
            "fax_number": "414-475-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 W VLIET ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132485",
            "telephone_number": "414-475-9035",
            "fax_number": "414-475-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND PARK FAMILY DENTISTRY, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-13",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-475-9035",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WI",
            "license": "4097",
            "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 Jul 13, 2012; 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.