WISCONSIN DENTAL GROUP, S.C. (NPI# 1528198785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1528198785 |
Entity Type | Organization |
Organization Name | WISCONSIN DENTAL GROUP, S.C. |
Other Organization Name | FORWARD DENTAL |
Practice Address |
W231n1440 Corporate Ct Suite 211 Waukesha WI 53186-1303 |
Practice Telephone | 2625241072 |
Mailing Telephone | 2625241072 |
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 | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
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 |
W231N1440 CORPORATE CT SUITE 211 |
City | WAUKESHA |
State | WI |
Zip Code | 53186-1303 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699769596 | Cindy B Catania | Family Medicine | W231n1440 Corporate Ct, Waukesha, WI 53186-1303 | 2005-09-07 |
1518588672 | Amy Gelhaar | Physical Therapist | W231n1440 Corporate Ct, Waukesha, WI 53186-1303 | 2020-04-29 |
1801441167 | Megan R Menapace | Physician Assistant | W231n1440 Corporate Ct, Waukesha, WI 53186-1303 | 2019-08-05 |
1770006835 | Kari Brueck | Nurse Practitioner | W231n1440 Corporate Ct, Waukesha, WI 53186-1303 | 2017-07-20 |
1114479672 | Janet Harte | Physical Therapist | W231n1440 Corporate Ct, Waukesha, WI 53186-1303 | 2016-11-01 |
1649720145 | Jennifer Seeger-jaeschke | Occupational Therapist | W231n1440 Corporate Ct, Waukesha, WI 53186-1303 | 2016-10-07 |
1477003275 | Jennifer Vanderkamp | Physical Therapy Assistant | W231n1440 Corporate Ct, Waukesha, WI 53186-1303 | 2016-10-05 |
1609230861 | Danielle C Orrey | Family Medicine | W231n1440 Corporate Ct, Waukesha, WI 53186-1503 | 2016-04-13 |
1013393768 | Renelle L Staus | Nurse Practitioner | W231n1440 Corporate Ct, Waukesha, WI 53186 | 2015-08-05 |
1477943918 | Elyse M Hahn | Nurse Practitioner | W231n1440 Corporate Ct, Waukesha, WI 53186-1303 | 2015-02-04 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295391472 | Christine Lowdon Triggs | Dentist | 21680 West Bluemound Rd, Waukesha, WI 53186 | 2019-05-14 |
1881182889 | Allure Medical of Wisconsin Pllc | Clinic/Center | 1930 W Bluemound Rd Ste 340, Waukesha, WI 53186 | 2018-04-25 |
1316462104 | Mary B Mckee | Dietitian, Registered | 22370 W Bluemound Rd, #102, Waukesha, WI 53186 | 2017-08-14 |
1740738343 | Rebecca Menelle | Physical Therapist | 1809 Shepherd Ct, Apt 206, Waukesha, WI 53186 | 2016-09-13 |
1568919876 | Dianne Isnard | Physical Therapist | W231n1440 Corporate Court, Waukesha, WI 53186 | 2016-09-02 |
1982065991 | Brandon James Decker | Nurse Practitioner | 21775 Hillcrest Drive, Waukesha, WI 53186 | 2016-03-18 |
1598142937 | Sophia Marie Klingbiel | Social Worker | 1515 Paramount Dr., Waukesha, WI 53186 | 2015-05-06 |
1326478165 | Glen D Haberman | Dentist | 141 Wisconsin Avenue, Waukesha, WI 53186 | 2013-11-14 |
1487991014 | Sara Nicole Francis | Counselor | 217 Wisconsin Ave Ste 211, Waukesha, WI 53186 | 2013-01-16 |
1770862054 | Alex Colque, M.d. S.c. | Plastic Surgery | 21675 E Moreland Blvd, Suite 100, Waukesha, WI 53186 | 2011-08-04 |
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Taxonomy Code | 1223X0400X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Orthodontics and Dentofacial Orthopedics |
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295391472 | Christine Lowdon Triggs | Dentist | 21680 West Bluemound Rd, Waukesha, WI 53186 | 2019-05-14 |
1578941548 | Bubon & Associates, Orthodontics, Sc | Dentist | N4w21680 Bluemound Rd, Waukesha, WI 53186-2943 | 2015-05-11 |
1649313453 | Charles L Evans | Dentist | 2140 W Saint Paul Ave Ste A, Waukesha, WI 53188-5905 | 2007-02-14 |
1902990831 | Peter G Reichl | Dentist | 2140 W Saint Paul Ave, Suite A, Waukesha, WI 53188-9541 | 2006-10-03 |
1316956402 | Kirk Robert Davies | Dentist | 2117 Corporate Dr, Suite 300, Waukesha, WI 53189-7994 | 2006-08-06 |
1265497564 | Michael S Bubon | Dentist | N16w24132 Prairie Ct, Suite 150, Waukesha, WI 53188-1178 | 2006-04-19 |
1780221440 | Benjamin J Schneider | Dentist | N14w23833 Stone Ridge Dr, Waukesha, WI 53188-1157 | 2019-12-02 |
1457530941 | Peter G. Reichl D.d.s., Sc | Dentist | 2140 W Saint Paul Ave Ste A, Waukesha, WI 53188-5905 | 2007-10-31 |
1194868802 | Evonne Evans | Dentist | 2140 W Saint Paul Ave Ste A, Waukesha, WI 53188-5905 | 2007-02-14 |
1841333564 | Charles L. Evans Dds Sc | Dentist | 2140 W Saint Paul Ave Ste A, Waukesha, WI 53188-5905 | 2007-02-14 |
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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.