Brady John Gerber, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

600156915 Issued in WI

Practice address

580 Broad St
Lake Geneva, WI 53147-1420

Phone

(262) 248-2773

NPI assigned

Jun 12, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lake Geneva Dental Care LLC

  • General Practice Dentistry
  • Lake Geneva, WI
  • NPI 1083732101
  NPD (past)

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1740022342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 BROAD ST",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471420",
            "telephone_number": "262-248-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 BROAD ST",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471420",
            "telephone_number": "262-248-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERBER",
        "first_name": "BRADY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "600156915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheylin Aubrey Galica, COTA
• Rhonda Ganansky, MD
• Krystalann Garmon, BCBA
• James William Gelder, PA-C
• Geneva Family Dentistry
• Greg James Gerber, MD
• Daniel Gerblick II
• Matthew J Geyso, PTA
• Inger L Gibson, OD
• Kristine Goebel, SLP

• General Practice Dentistry in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.