Pamela Ann Gentile, DDS
Individual provider Active NPI General Practice Dentistry · West Milwaukee, WI
NPI 1720110281 · NPPES record last updated Jan 10, 2023
Key facts
- NPI
- 1720110281
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 1002478 (WI)
- Practice address
- 2100 Miller Park Way
West Milwaukee, WI 53219-1641 - Phone
- (414) 645-4540
- NPI assigned
- Mar 11, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Dentist
- Education
- Baylor College of Dentistry/Texas a&M University, 2005
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3522 W Lisbon Ave
Milwaukee, WI 53208-1953
9859 Graduate Driveway
Unit 404
San Diego, CA 92131-2510
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260331003252 | WI | Practitioner - Dentist | 4981908936 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1002478 | WI | MD | General Practice Dentistry |
| 6767 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Associates LTD of Wisconsin | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6767 | AZ | |
| General Practice Dentistry | 1223G0001X | 1002478 | WI | Yes |
Addresses
Primary practice location
2100 Miller Park Way
West Milwaukee, WI 53219-1641
Mailing address
7571 W Tuckaway Pines Cir
Franklin, WI 53132-8178
Phone (801) 691-1701
Other providers in West Milwaukee, WI
- Aaron Foss
- Cory E Foster
- Carolynn Fox
- Fresh Coast Dental I LLC
- Lynn A Garnaas
- Aleksandr Gershteyn
- Epiphany A Gold
- Laura Elizabeth Goodell
- Sandra Graham
- Great Lakes Orthotics & Medical Supply, Inc.
All providers in West Milwaukee, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.