Individual provider Active NPI

Paula Gomez, DDS

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1952724320
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7201-15 Issued in WI
Practice address
1801 W Wisconsin Ave RM 141
Milwaukee, WI 53233-2186
Phone
(414) 288-7388
NPI assigned
Jan 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7201-15 WI Primary

Addresses

Primary practice location

1801 W Wisconsin Ave RM 141
Milwaukee, WI 53233-2186

Mailing address

10190 W Plum Tree Cir
Hales Corners, WI 53130-2660
Phone (561) 827-6067

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
I20160609000435 WI Order and Referring Only - DentistPractitioner - Dentist 9537459144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1952724320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10190 W PLUM TREE CIR",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302660",
            "telephone_number": "561-827-6067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W WISCONSIN AVE RM 141",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332186",
            "telephone_number": "414-288-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "PAULA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "7201-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.