WISCONSIN DENTAL GROUP, S.C. (NPI# 1336279975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336279975 |
| Entity Type | Organization |
| Organization Name | WISCONSIN DENTAL GROUP, S.C. |
| Other Organization Name | FORWARD DENTAL |
| Practice Address |
8801 W National Ave West Allis WI 53227-1635 |
| Practice Telephone | 4143276363 |
| Practice Fax Number | 4143276304 |
| Mailing Telephone | 4143276363 |
| Mailing Fax Number | 4143276304 |
| 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 | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Forward Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881726412 | Wisconsin Dental Group, S.c. | Dentist | 5100 W Forest Home Ave, Milwaukee, WI 53219-4527 | 2007-03-09 |
| 1952431090 | Wisconsin Dental Group, S.c. | Dentist | 15100 W. Library Lane, New Berlin, WI 53151 | 2007-03-07 |
| 1366572927 | Wisconsin Dental Group, S.c. | Dentist | 6218 Washington Ave Ste C, Racine, WI 53406-3916 | 2007-03-06 |
| 1194855742 | Wisconsin Dental Group, S.c. | Dentist | 1025 S Moorland Rd Ste 201, Brookfield, WI 53005-6945 | 2007-03-06 |
| 1417087479 | Wisconsin Dental Group, S.c. | Dentist | 705 S 24th Ave, The Galleria, Suite 430, Wausau, WI 54401-5242 | 2007-03-07 |
| 1548390404 | Wisconsin Dental Group, S.c. | Dentist | 10058 W Loomis Rd, Franklin, WI 53132-8109 | 2007-03-07 |
| 1023148681 | Wisconsin Dental Group, S.c. | Dentist | 1407 N Wright Rd, Janesville, WI 53546-1314 | 2007-03-06 |
| 1144350703 | Wisconsin Dental Group, S.c. | Dentist | 3410 80th St, Kenosha, WI 53142-4975 | 2007-03-06 |
| 1437289006 | Wisconsin Dental Group, S.c. | Dentist | 3715 Washington Rd, Kenosha, WI 53144-1629 | 2007-03-06 |
| 1578693149 | Wisconsin Dental Group, S.c. | Dentist | N80w17707 Custer Ln, Menomonee Falls, WI 53051-3630 | 2007-03-06 |
| Street Address |
8801 W NATIONAL AVE |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53227-1635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508923657 | Conor Casey | Dentist | 8801 W National Ave, West Allis, WI 53227-1635 | 2007-01-01 |
| 1992862437 | Zachary Schmidt | Dentist | 8801 W National Ave, West Allis, WI 53227-1635 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451564 | Ginger Renee Bland | Nurse Practitioner | 11133 W. National Avenue, West Allis, WI 53227 | 2020-06-12 |
| 1003312141 | Dynamic Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 10236 W National Ave, West Allis, WI 53227 | 2018-04-05 |
| 1932572641 | Alissa Kristine Walker | Specialist/Technologist | 11601 W Lincoln Ave, West Allis, WI 53227 | 2015-11-03 |
| 1396155990 | Bradly Earl Helinski | Physical Therapy Assistant | 3023 S 84th St., Milwaukee, WI 53227 | 2014-05-05 |
| 1609299783 | Amy Renee Rozumalski | Occupational Therapy Assistant | 10150 W. National Ave, Suite 150, Premiere Medical Staffing Services, LLC, Milwaukee, WI 53227 | 2014-01-27 |
| 1497098438 | Kathleen Marie Schneider | Physical Therapy Assistant | 3023 S. 84th Street, Milwaukee, WI 53227 | 2013-03-28 |
| 1760723373 | Lee Ann Schraith | Physical Therapy Assistant | 3023 S. 84th St, Milwaukee, WI 53227 | 2013-03-06 |
| 1740520725 | Samantha Lynn Wozniak | Physical Therapist | 3023 S. 84th St., Milwaukee, WI 53227 | 2013-02-27 |
| 1831434901 | Andrew Paul Roeder | Physical Therapy Assistant | 3023 S. 89th Street, Milwaukee, WI 53227 | 2012-11-30 |
| 1538418116 | Christine Wilford | Social Worker | 2044 S 96th Street, West Allis, WI 53227 | 2012-08-29 |
| Find all providers in zip 53227 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760684930 | Jeffrey Joseph Burke | Dentist | 2323 S 109th St Ste 275, West Allis, WI 53227-1912 | 2007-06-01 |
| 1295930634 | American Dental Specialty Institute, Sc | Dentist | 2323 S 109th St, Suite 275, West Allis, WI 53227-1909 | 2007-06-17 |
| 1871693747 | Andrew Dentino | Dentist | 555 S 108th St, West Allis, WI 53214-1100 | 2006-09-22 |
| 1801907886 | Ahmad Eslami | Dentist | 2323 S 109th St, Suite # 275, West Allis, WI 53227-1909 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235683830 | Phillip Crum | Dentist | 2581 Development Dr Ste 204, Bellevue, WI 54311-4248 | 2016-08-11 |
| 1285937557 | Craig William Byers | Dentist | 2457 North Mayfair Road, Suite 102, Wauwatosa, WI 53226-1405 | 2010-12-08 |
| 1558662387 | Jason William Cooke | Dentist | 2557b E Calumet St, Appleton, WI 54915-4748 | 2010-11-10 |
| 1780998997 | Thomas C. Kelley Dds Msd LLC | Dentist | 17280 W North Ave Ste 203, Brookfield, WI 53045-4366 | 2010-07-29 |
| 1376789933 | Shoreline Periodontics Limited | Dentist | 2808 Kohler Memorial Dr, Suite 2, Sheboygan, WI 53081-3177 | 2008-12-31 |
| 1003052895 | James P. Herman | Dentist | 5624 S Bonnie Ln, Hales Corners, WI 53130-1674 | 2008-12-28 |
| 1992915276 | Scott George Metskas | Dentist | 3364 Iris Ln, Stevens Point, WI 54481-5618 | 2007-05-23 |
| 1134339500 | Fox River Periodontics Sc | Dentist | 2557b East Calumet St, Appleton, WI 54915 | 2007-05-23 |
| 1891903043 | Denise Y Shih | Dentist | 2853 N Marietta Ave, Milwaukee, WI 53211-3420 | 2007-05-20 |
| 1629280987 | Nancy Ellen Shumate | Dentist | 2600 N Mayfair Rd Ste 340, Wauwatosa, WI 53226-1372 | 2007-05-07 |
| Find all providers with the same taxonomy | ||||
| City | WEST ALLIS |
| Zip Code | 53227 |
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.