Sheppard B Mollick, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5001300-015 Issued in WI

Practice address

10535 N Port Washington Rd
Suite 102
Mequon, WI 53092-5583

Phone

(414) 241-0900

Fax

(414) 241-0904

NPI assigned

Oct 2, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Oral Surgery Associates of Milwaukee SC

  • Oral and Maxillofacial Surgery (Dentist)
  • Mequon, WI
  • NPI 1477647832
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1962596395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 N PORT WASHINGTON RD",
            "address_2": "SUITE 102",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925583",
            "telephone_number": "414-241-0900",
            "fax_number": "414-241-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 N PORT WASHINGTON RD",
            "address_2": "SUITE 102",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925583",
            "telephone_number": "414-241-0900",
            "fax_number": "414-241-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLICK",
        "first_name": "SHEPPARD",
        "middle_name": "B",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "5001300-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carley Skye Mitz, PHARMD
• Rachel Mix
• Mitchell Edward Mleziva
• Elizabeth Cohn Mock, OT
• Jaclyn A Moglowsky, MA, LPC
• Sarah Mooney, MD
• Ashley Moore, AESTHETICIAN
• Candace Moore, NP
• Stephen James Moore, PHARM. D.
• Gregg Moral, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Mequon, WI
• Providers in Mequon, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.