Individual provider Active NPI

Michael Dentice, PHARM D.

  • Ambulatory Care Pharmacist
  • Milwaukee, WI
National Provider Identifier
1902394570
Registry record updated Apr 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
19175-40 Issued in WI
Practice address
11111 W Burleigh St
Milwaukee, WI 53222-3211
Phone
(414) 290-0910
NPI assigned
Apr 28, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X 19175-40 WI Primary

Addresses

Primary practice location

11111 W Burleigh St
Milwaukee, WI 53222-3211

Mailing address

N111W16153 Catskill LN
Germantown, WI 53022-4072
Phone (262) 327-6018

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
19175-40WIMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1524873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524873600000",
    "number": "1902394570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N111W16153 CATSKILL LN",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530224072",
            "telephone_number": "262-327-6018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 W BURLEIGH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532223211",
            "telephone_number": "414-290-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENTICE",
        "first_name": "MICHAEL",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-28",
        "last_updated": "2018-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "WI",
            "license": "19175-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2018; 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.