Active NPI
David Trizzino, DMD
- Dentist
- Lomira, WI
National Provider Identifier
1861046120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1002115-15
- Practice address
- 717 S Water St
Lomira, WI 53048-9349 - Phone
- (920) 269-4453
- NPI assigned
- Jul 25, 2019
- 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 | 1002115-15 | WI | |
| Dentist | 122300000X | 1002115-15 | WI | Primary |
Addresses
Primary practice location
717 S Water St
Lomira, WI 53048-9349
Mailing address
1623 N Jackson St Apt 308
Milwaukee, WI 53202-2777
Other practice location 1
2700 W Lincoln Ave
Milwaukee, WI 53215-4606
Phone (414) 645-0217
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1002115-15 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincoln Ave Dental Group SC | General Practice | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Milwaukee, WI
- NPI 1861595324
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612828800000",
"number": "1861046120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1623 N JACKSON ST APT 308",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532022777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "717 S WATER ST",
"city": "LOMIRA",
"state": "WI",
"postal_code": "530489349",
"telephone_number": "920-269-4453"
}
],
"practiceLocations": [
{
"address_1": "2700 W Lincoln Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532154606",
"country_code": "US",
"telephone_number": "414-645-0217",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRIZZINO",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-25",
"last_updated": "2021-02-09",
"certification_date": "2021-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "1002115-15",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "1002115-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lomira, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.