WISCONSIN DENTAL GROUP,S.C. (NPI# 1265562631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265562631 |
| Entity Type | Organization |
| Organization Name | WISCONSIN DENTAL GROUP,S.C. |
| Other Organization Name | FORWARD DENTAL |
| Practice Address |
7040 N Port Washington Rd Glendale WI 53217-3838 |
| Practice Telephone | 4143516010 |
| Practice Fax Number | 4143516148 |
| Mailing Telephone | 4143516010 |
| Mailing Fax Number | 4143516148 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PETER YOUNG (VP) |
| Authorized Official Telephone | 4143572040 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Forward Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023148301 | Wisconsin Dental Group,s.c. | Dentist | 6218 Washington Ave, Suite C, Racine, WI 53406-3916 | 2007-03-06 |
| 1568592905 | Wisconsin Dental Group,s.c. | Dentist | W231n1440 Corporate Ct, Suite 211, Waukesha, WI 53186-1303 | 2007-03-06 |
| 1467582833 | Wisconsin Dental Group,s.c. | Dentist | 9052 N Deerbrook Trl, Milwaukee, WI 53223-2474 | 2007-03-06 |
| Street Address |
7040 N PORT WASHINGTON RD |
| City | GLENDALE |
| State | WI |
| Zip Code | 53217-3838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821047283 | James Edward Berman | Dermatology | 7040 N Port Washington Rd, Suite 404, Glendale, WI 53217-3885 | 2006-05-10 |
| 1245506971 | Forefront Dermatology, S.c. | Dermatology | 7040 N Port Washington Rd, Suite 404, Glendale, WI 53217 | 2012-03-27 |
| 1891068599 | Petrou-haefs Eyecare, LLC | Clinic/Center | 7040 N Port Washington Rd, Suite 420, Glendale, WI 53217-3885 | 2012-02-12 |
| 1114183126 | Liberty Ann Boucher | Dentist | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2008-07-30 |
| 1427234723 | Joseph L Gaffney | Dentist | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2008-01-16 |
| 1972710077 | Daniel C Ross | Student in an Organized Health Care Education/Training Program | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2007-05-17 |
| 1003946252 | Wisconsin Dental Group, S.c. | Dentist | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2007-03-06 |
| 1346380979 | James Lipinski | Dentist | 7040 N Port Washington Rd, Ste 414, Glendale, WI 53217-3838 | 2007-02-06 |
| 1508936154 | Northeast Obgyn Sc | Obstetrics & Gynecology | 7040 N Port Washington Rd, Suite 400, Glendale, WI 53217-3838 | 2006-11-09 |
| 1942380522 | Stephanie Ann Murphy | Dentist | 7040 N Port Washington Rd, 410, Glendale, WI 53217-3838 | 2006-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632587 | Jasmine Dockery | Pharmacist | 5400 N Port Washington, Glendale, WI 53217 | 2020-02-23 |
| 1174017339 | North Lakes Nursing Home Health Care Agency LLC | Home Health | 225 E Fairmount Ave, Milwaukee, WI 53217 | 2018-06-20 |
| 1083140289 | Miriah Ann King, Ms, Lpc | Counselor | 7805 North Boyd Way, Fox Point, WI 53217 | 2017-05-08 |
| 1245783067 | Lakesha L Jones | Counselor | 5235 N Ironwood Rd, Glendale, WI 53217 | 2016-07-28 |
| 1750783312 | Ibrahim S Abouzeid | Specialist/Technologist, Other | 333 W Brown Deer Road, #240, Milwaukee, WI 53217 | 2014-09-25 |
| 1255733598 | Victoria Gorodetsky | Pharmacist | 229 W Indian Creek Ct, Milwaukee, WI 53217 | 2014-09-18 |
| 1174800049 | John Herman Esser | Internal Medicine | 1050 W Acacia Rd, Milwaukee, WI 53217 | 2011-11-07 |
| 1710298351 | Leann M Harman | Physical Therapist | 5333 N Port Washington Rd Ste B, Glendale, WI 53217 | 2010-06-29 |
| 1306012455 | Emily Marie Gallagher | Speech-Language Pathologist | 6700 N. Port Washington Road, Milwaukee, WI 53217 | 2008-05-07 |
| 1164625455 | Mary Catherine Enderlin | Psychologist | 6110 N Port Washington Road, The Cambridge Group, Glendale, WI 53217 | 2007-06-06 |
| Find all providers in zip 53217 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629574389 | Anna Lala Shahinian | Dentist | 331 N Cedar St Apt 12, Glendale, CA 91206-3795 | 2018-04-02 |
| 1841704764 | Highbury Dental Management, LLC | Dentist | 5757 W Thunderbird Rd Ste E451, Glendale, AZ 85306-4645 | 2017-11-30 |
| 1306372503 | Wopd Pllc | Dentist | 5144 W Olive Ave, Glendale, AZ 85302-4209 | 2017-05-08 |
| 1386999779 | Yvonne Shuwa Lee | Dentist | 1808 Verdugo Hills, Suite 312, Glendale, CA 91208-1456 | 2012-07-21 |
| 1578859567 | Arina V Hartunian | Dentist | 418 E. Glenoaks Blvd., Kids Dental Place, Suite # 202, Glendale, CA 91207 | 2011-06-28 |
| 1043525736 | Tiffany Andersen | Dentist | 5757 W Thunderbird Rd Ste 451, Glendale, AZ 85306-4645 | 2010-08-18 |
| 1275858003 | Shakeh Garibyan | Dentist | 539 Salem St Apt 3, Glendale, CA 91203-2144 | 2010-04-05 |
| 1750462826 | Jane Marie Thomason | Dentist | 18700 N 64th Dr Ste 302, Glendale, AZ 85308-7114 | 2006-10-17 |
| 1497850002 | Natalie Chantal Mansour | Dentist | 709 S Central Ave, Glendale, CA 91204-2010 | 2006-09-14 |
| 1952301582 | Lisa Carlson-marks | Dentist | 4500 Cherry Creek South Dr, # 840, Glendale, CO 80246-1518 | 2005-07-26 |
| Find all providers in GLENDALE | ||||
Please comment or provide details below to improve the information on WISCONSIN DENTAL GROUP,S.C..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.