Progressive Periodonitics and Dental Implants

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2918 Issued in WI

Legal business name

PROGRESSIVE PERIODONITICS AND DENTAL IMPLANTS

Practice address

8405 W Forest Home Ave
Suite 203
Greenfield, WI 53228-3407

Phone

(414) 425-7710

Fax

(414) 425-7424

NPI assigned

Jan 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Timothy J McNamara, D.D.S.NPI 1598773764

Title

President

Phone

(414) 425-7710

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy J McNamara, DDS

  • Periodontics
  • Greenfield, WI
  • NPI 1598773764
  NPD (past) Authorized official

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962553834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8405 W FOREST HOME AVE",
            "address_2": "SUITE 203",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283407",
            "telephone_number": "414-425-7710",
            "fax_number": "414-425-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8405 W FOREST HOME AVE",
            "address_2": "SUITE 203",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283407",
            "telephone_number": "414-425-7710",
            "fax_number": "414-425-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PERIODONITICS AND DENTAL IMPLANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCNAMARA",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-425-7710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "WI",
            "license": "2918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaac A Pratzel
• Preferred Rehabilitation and Orthopedic Care Center S.C.
• Premier Periodontics LLC
• Pauline Ann Preuss, MA
• Kimberly Ann Pritchard, LPC, NCC
• Richard Eward Protasiewicz Jr., D.C.
• Patrick Quane, HCP
• William Quebrado, PT
• Alexandria Irene Rabe, DPT
• Alexander James Radish, PHARM.D.

• Periodontics in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Periodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.