Peter P Colosimo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5000888015 Issued in WI

Practice address

3970 N Oakland Ave
#702
Shorewood, WI 53211

Phone

(414) 332-8150

Fax

(414) 332-6202

NPI assigned

Apr 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Molars by Mueller

  dba Shorewood Family Dentistry

  • General Practice Dentistry
  • Shorewood, WI
  • NPI 1477438679
  NPD (past)
• Shorewood Family Dentistry, LLC

  • General Practice Dentistry
  • Shorewood, WI
  • NPI 1336803600
  NPD (past)

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952521098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 N OAKLAND AVE",
            "address_2": "#702",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "53211",
            "telephone_number": "414-332-8150",
            "fax_number": "414-332-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 N OAKLAND AVE",
            "address_2": "#702",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "53211",
            "telephone_number": "414-332-8150",
            "fax_number": "414-332-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLOSIMO",
        "first_name": "PETER",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5000888015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noel Anne Clark, MS CCC SLP
• Tayler Simone Clark, LCSW
• Robert Edward Coleman Jr., ND, LMT
• Salonda Coleman
• Peter James Colosimo, D.D.S.
• Alisa Renee Conroy, PHARMD
• Kevan M Creighton, ATC
• Crux Chiropractic, LLC
• Crystalkinetics, LLC
• Alexander Ford Curtis, OD

• Dentist in Shorewood, WI
• Providers in Shorewood, WI by specialty
• Dentist in Wisconsin

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.