Omalley Dentistry SC

Primary specialty

DentistTaxonomy code 122300000X

License

3802 Issued in WI

Legal business name

OMALLEY DENTISTRY SC

Practice address

8555 W Forest HM Ave
Suite 101
Greenfield, WI 53228

Phone

(414) 425-4005

Fax

(414) 529-9777

NPI assigned

Nov 1, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Glen Martin Omalley, DDSNPI 1205090537

Title

Dentist Owner

Phone

(414) 425-4005

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Glen Martin O'Malley, D.D.S., S.C.

  • General Practice Dentistry
  • Greenfield, WI
  • NPI 1205090537
  Authorized official Same address or phone

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750468732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8555 W FOREST HM AVE",
            "address_2": "SUITE 101",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "53228",
            "telephone_number": "414-425-4005",
            "fax_number": "414-529-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8555 W FOREST HM AVE",
            "address_2": "SUITE 101",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "53228",
            "telephone_number": "414-425-4005",
            "fax_number": "414-529-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMALLEY DENTISTRY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OMALLEY",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "414-425-4005",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "3802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Jane O'Herron, PHARMD
• Glen Martin O'Malley, D.D.S., S.C.
• Jennifer A O'Neil, RN
• Shaawn Olds
• David Olson, MD
• Hamza Omar
• Ophthalmology Associates S C
• Bisrat Oqubay
• Oral & Maxillofacial Surgery Consultants of Wisconsin, S.C.
• Melanie J Orlando

• Dentist in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.