Individual provider Active NPI

Robert Lew Salnick, D.D.S.

  • General Practice Dentistry
  • Waukesha, WI
National Provider Identifier
1760570154
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5001362 - 015 Issued in WI
Practice address
2120 E Moreland Blvd
G
Waukesha, WI 53186-4038
Phone
(262) 544-0300
Fax
(262) 544-4884
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5001362 - 015 WI Primary

Addresses

Primary practice location

2120 E Moreland Blvd
G
Waukesha, WI 53186-4038

Mailing address

2120 E Moreland Blvd
G
Waukesha, WI 53186-4038
Phone (262) 544-0300

Other identifiers 1

IdentifierTypeStateIssuer
5001362 - 015OtherWISTATE DENTISTRY NUMBER

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160106002880 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1254633373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5001362 - 015WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760570154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 E MORELAND BLVD",
            "address_2": "G",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864038",
            "telephone_number": "262-544-0300",
            "fax_number": "262-544-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 E MORELAND BLVD",
            "address_2": "G",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864038",
            "telephone_number": "262-544-0300",
            "fax_number": "262-544-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALNICK",
        "first_name": "ROBERT",
        "middle_name": "LEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001362 - 015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTISTRY NUMBER",
            "identifier": "5001362 - 015",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.