Active NPI
John Jay Finnessy, DMD
- General Practice Dentistry
- Wauwatosa, WI
National Provider Identifier
1790720720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- WI-5060
- Practice address
- 11711 W Burleigh St
Wauwatosa, WI 53222-3108 - Phone
- (414) 771-2345
- Fax
- (414) 777-3839
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | WI-5060 | WI | Primary |
| General Practice Dentistry | 1223G0001X | 7771 | CO |
Addresses
Primary practice location
11711 W Burleigh St
Wauwatosa, WI 53222-3108
Mailing address
204 E Laurel Cir
Delafield, WI 53018-1162
Phone (414) 771-2345
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33750600 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7771 | CO | MD | General Practice Dentistry |
| WI-5060 | WI | MD | General Practice Dentistry |
| 5060 | WI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790720720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 E LAUREL CIR",
"city": "DELAFIELD",
"state": "WI",
"postal_code": "530181162",
"telephone_number": "414-771-2345",
"fax_number": "414-777-3839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11711 W BURLEIGH ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532223108",
"telephone_number": "414-771-2345",
"fax_number": "414-777-3839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FINNESSY",
"first_name": "JOHN",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "WI-5060",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "7771",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33750600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.