Wisconsin Oral Surgery & Dental Implants, S.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5420-015 Issued in WI

Legal business name

WISCONSIN ORAL SURGERY & DENTAL IMPLANTS, S.C.

Practice address

10401 W Lincoln Ave
Suite 101
West Allis, WI 53227-1255

Phone

(414) 327-4130

Fax

(414) 327-4218

NPI assigned

Jan 26, 2007

Last updated

Mar 29, 2021By 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

Dr. Anthony L Ragonese, DDSNPI 1649350398

Title

President

Phone

(414) 327-4130

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

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.

• Anthony L Ragonese, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • West Allis, WI
  • NPI 1649350398
  Medicare reassignment NPD Authorized official
• Slaton Hoffner, D.D.S.

  • Dental Anesthesiology
  • Palatine, IL
  • NPI 1295123529

  WI

  Medicare reassignment NPD

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1760538490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 W LINCOLN AVE",
            "address_2": "SUITE 101",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271255",
            "telephone_number": "414-327-4130",
            "fax_number": "414-327-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 W LINCOLN AVE",
            "address_2": "SUITE 101",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271255",
            "telephone_number": "414-327-4130",
            "fax_number": "414-327-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN ORAL SURGERY & DENTAL IMPLANTS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "RAGONESE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-327-4130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "5420-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33795900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Alynn Winzer, LPN
• Wisconsin CVS Pharmacy LLC (CVS Pharmacy #17277)
• Wisconsin CVS Pharmacy LLC (CVS Pharmacy #05676)
• Wisconsin Dental Group, S.C. (ForwardDental West Allis)
• Wisconsin Medical Group
• Wisconsin Oral Surgery LLC
• Wisconsin Renal Care Group, L.L.C. (WRCG Centre Point)
• Wisconsin Vision, LLC
• Ashly Marie Witkowiak, LCSW
• Steven Wittig, P.T.

• Oral and Maxillofacial Surgery (Dentist) in West Allis, WI
• Providers in West Allis, 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 Mar 29, 2021; 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.