NPIMap

Organization Active NPI

Major Dental Clinics of Milwaukee S.C.

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1710330725
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6468 Issued in WI
Legal business name
MAJOR DENTAL CLINICS OF MILWAUKEE S.C.
Practice address
788 N Jefferson St
Suite 880
Milwaukee, WI 53202-3718
Phone
(414) 276-4262
Fax
(414) 276-4269
NPI assigned
Jul 14, 2016
Last updated
Jul 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Authorized official

Name
Daniel Domagala, D.D.S.,M.S.
Title
President
Phone
(414) 276-4262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6468 WI Primary

Addresses

Primary practice location

788 N Jefferson St
Suite 880
Milwaukee, WI 53202-3718

Mailing address

788 N Jefferson St
Suite 880
Milwaukee, WI 53202-3718
Phone (414) 276-4262

Other identifiers 1

IdentifierTypeStateIssuer
6468OtherWILICENSE

National Provider Directory

National Provider Directory

Locations

788 N Jefferson St
Ste 880
Milwaukee, WI 53202
Phone (414) 276-4262

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": "1468454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1710330725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 N JEFFERSON ST",
            "address_2": "SUITE 880",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023718",
            "telephone_number": "414-276-4262",
            "fax_number": "414-276-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 N JEFFERSON ST",
            "address_2": "SUITE 880",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023718",
            "telephone_number": "414-276-4262",
            "fax_number": "414-276-4269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJOR DENTAL CLINICS OF MILWAUKEE S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "DOMAGALA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-276-4262",
        "authorized_official_credential": "D.D.S.,M.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6468",
            "state": "WI"
        }
    ],
    "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 Jul 14, 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.

Verify at the official NPI Registry.