Oral Surgery Associates of Milwaukee

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4130-015 Issued in WI

Legal business name

ORAL SURGERY ASSOCIATES OF MILWAUKEE

Practice address

800 North Mayfair Road
Suite 130
Wauwatosa, WI 53226

Phone

(262) 798-0800

Fax

(262) 798-0851

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Alan A Kimmel, DDSNPI 1760576128

Title

President

Phone

(262) 241-0900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Oral Surgery Associates of Milwaukee SC

  • Oral and Maxillofacial Surgery (Dentist)
  • Mequon, WI
  • NPI 1477647832

  O20040310000440

  Same enrollment
• Oral Surgery Associates of Milwaukee SC

  • Oral and Maxillofacial Surgery (Dentist)
  • Oak Creek, WI
  • NPI 1780850263

  O20040310000440

  Same enrollment

Tax ID family

Oral Surgery Associates of Milwaukee SC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Oral Surgery Associates of Milwaukee SC

  • Oral and Maxillofacial Surgery (Dentist)
  • Mequon, WI
  • NPI 1477647832
  NPD tax ID
• Oral Surgery Associates of Milwaukee SC

  • Oral and Maxillofacial Surgery (Dentist)
  • Oak Creek, WI
  • NPI 1780850263
  NPD tax ID

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alan A Kimmel, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Mequon, WI
  • NPI 1760576128
  NPD Authorized official
• Brian Rezel Carr, DMD MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Oak Creek, WI
  • NPI 1093270217
  NPD (past)
• Mark J Kortebein, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Mequon, WI
  • NPI 1336233790
  NPD (past)
• Gregory A. Santarelli, DDS SC

  • Oral and Maxillofacial Surgery (Dentist)
  • Kenosha, WI
  • NPI 1578640488
  NPD (past)
• Peter Louis Wagner, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Mequon, WI
  • NPI 1548356280
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753833600000",
    "number": "1720172992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 NORTH MAYFAIR ROAD",
            "address_2": "SUITE 130",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "262-798-0800",
            "fax_number": "262-798-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 NORTH MAYFAIR ROAD",
            "address_2": "SUITE 130",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "262-798-0800",
            "fax_number": "262-798-0851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY ASSOCIATES OF MILWAUKEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "KIMMEL",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-241-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "4130-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.