DR. HENRY NISHAN AMBROOKIAN JR. (NPI# 1295841203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295841203 |
| Entity Type | Individual |
| Full Name | DR. HENRY NISHAN AMBROOKIAN JR. |
| Credential | D.D.S. |
| Practice Address |
1201 Oak St West Bend WI 53095-3800 |
| Mailing Address |
11405 N Carriage Ct Mequon WI 53092-2145 |
| Practice Telephone | 2623347172 |
| Practice Fax Number | 2623347166 |
| Mailing Telephone | 2622422350 |
| Mailing Fax Number | 2622381472 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5001837-015 | WI | Dental Providers |
| Street Address |
1201 OAK ST |
| City | WEST BEND |
| State | WI |
| Zip Code | 53095-3800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861870420 | Bubon & Associates, Orthodontics, Sc | Dentist | 1201 Oak St, Suite G, West Bend, WI 53095-3800 | 2015-05-14 |
| 1033515986 | Scott Bartell | Acupuncturist | 1201 Oak St, Suite H, West Bend, WI 53095-3800 | 2014-11-04 |
| 1710289608 | Earl W Nepple M.d. | Eyewear Supplier (Equipment, not the service) | 1201 Oak St, West Bend, WI 53095-3800 | 2010-11-26 |
| 1215163746 | Hazel M Hanson | Nurse Practitioner | 1201 Oak St, West Bend, WI 53095-3800 | 2009-06-10 |
| 1982850343 | Pamela Anne Schall | Contractor | 1201 Oak St, Suite Q, West Bend, WI 53095-3800 | 2008-08-16 |
| 1356511679 | Michael C. Reineck, Md | Durable Medical Equipment & Medical Supplies | 1201 Oak St, West Bend, WI 53095-3800 | 2008-03-03 |
| 1942238274 | Stephen Robert Schacht | Dentist | 1201 Oak St, West Bend, WI 53095-3800 | 2006-06-28 |
| 1386621878 | Michael Charles Reineck | Orthopaedic Surgery | 1201 Oak St, West Bend, WI 53095-3800 | 2005-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
| 1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
| 1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
| 1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
| 1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
| 1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
| 1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
| 1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
| 1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
| 1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
| Find all providers in zip 53095 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235466988 | Oral Surgery Associates Ltd | Dentist | 2100 Gateway Ct, Suite 101, West Bend, WI 53095-8550 | 2009-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720569783 | Greater Milwaukee Oral Surgery, L.L.C. | Dentist | 4811 S 76th St Ste 304, Greenfield, WI 53220-4350 | 2018-08-27 |
| 1124516893 | Baycare Clinic, LLP | Dentist | 636 N 12th Ave, Sturgeon Bay, WI 54235-1249 | 2018-04-27 |
| 1477065787 | Central Wisconsin Oral and Facial Surgery, LLC | Dentist | 438 Edison St, Antigo, WI 54409-1845 | 2017-10-26 |
| 1497266910 | Donald Ervin Linneman | Dentist | Center 4820 N Sherman Road, Winnebago Correction Center, Drug Abuse Correctional, Winnebago, WI 54985-0036 | 2017-10-24 |
| 1063869485 | Tyler Kalmuck | Dentist | 3637 Wilgus Ave, Sheboygan, WI 53081-3050 | 2016-05-16 |
| 1952717753 | Judson Charles Smith | Dentist | 2323 N Mayfair Rd Ste 102, Milwaukee, WI 53226 | 2014-07-01 |
| 1073930459 | Paul Pamula | Dentist | 1925 S Green Bay Rd, Mount Pleasant, WI 53406-4654 | 2014-03-24 |
| 1326473927 | Lake Geneva Dental Care, LLC | Dentist | 1454 E Huebbe Pkwy, Beloit, WI 53511-1714 | 2013-09-13 |
| 1093154601 | Matthew D Reiland | Dentist | 2921 Landmark Pl Ste 100, Madison, WI 53713-4248 | 2013-06-17 |
| 1922364363 | Ell Louis Lee | Dentist | 2361 Lost Dauphin Rd, De Pere, WI 54115-9165 | 2012-04-10 |
| Find all providers with the same taxonomy | ||||
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| 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.