Individual provider Active NPI

Gil Todd Knutson, DDS

  • Dentist
  • Brookfield, WI
National Provider Identifier
1750382719
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2358 Issued in WI
Practice address
17585 W North Ave
Ste 210
Brookfield, WI 53045-4365
Phone
(262) 784-4222
Fax
(262) 784-4472
NPI assigned
Aug 2, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2358 WI Primary

Addresses

Primary practice location

17585 W North Ave
Ste 210
Brookfield, WI 53045-4365

Mailing address

17585 W North Ave
Ste 210
Brookfield, WI 53045-4365
Phone (262) 784-4222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150501000612 WI Order and Referring Only - Other (Non-Physician) 1557680295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2358WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brookfield Dental Center LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1750382719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17585 W NORTH AVE",
            "address_2": "STE 210",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530454365",
            "telephone_number": "262-784-4222",
            "fax_number": "262-784-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17585 W NORTH AVE",
            "address_2": "STE 210",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530454365",
            "telephone_number": "262-784-4222",
            "fax_number": "262-784-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "GIL",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "2358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.