CENTER FOR ORAL & MAXILLOFACIAL SURGERY SC (NPI# 1710900808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710900808 |
| Entity Type | Organization |
| Organization Name | CENTER FOR ORAL & MAXILLOFACIAL SURGERY SC |
| Practice Address |
7007 Old Sauk Rd Madison WI 53713 |
| Mailing Address |
20 S Park St #506 Madison WI 53715 |
| Practice Telephone | 6088332060 |
| Practice Fax Number | 6088331737 |
| Mailing Telephone | 6082561961 |
| Mailing Fax Number | 6082561501 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GARY W. SWEENEY (S CORP PRESIDENT) |
| Authorized Official Telephone | 6088332060 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 38390400 | 05 |
| Street Address |
7007 OLD SAUK RD |
| City | MADISON |
| State | WI |
| Zip Code | 53713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588611941 | David T Allen | Dentist | 7007 Old Sauk Rd, Suite 101, Madison, WI 53717-2307 | 2006-05-30 |
| 1376809129 | Tj Dyer | Dentist | 7007 Old Sauk Rd, Madison, WI 53717-2307 | 2012-04-05 |
| 1053689554 | Dha Orthodontics West LLC | Durable Medical Equipment & Medical Supplies | 7007 Old Sauk Rd, Suite 101, Madison, WI 53717-2307 | 2011-12-12 |
| 1811921950 | Gary W Sweeney | Dentist | 7007 Old Sauk Rd, Madison, WI 53717 | 2006-07-11 |
| 1346274487 | Jeffrey B Davis | Dentist | 7007 Old Sauk Rd, Madison, WI 53717 | 2006-07-11 |
| 1588699664 | Geoffrey R Warda | Dentist | 7007 Old Sauk Rd, Madison, WI 53717 | 2006-07-11 |
| 1003849100 | Dha Orthodontics West LLC | Dentist | 7007 Old Sauk Rd, Suite 101, Madison, WI 53717-2307 | 2006-07-09 |
| 1518990167 | Kim J Pansegrau | Dentist | 7007 Old Sauk Rd, Madison, WI 53717-2307 | 2006-07-08 |
| 1760420905 | James W Milne | Dentist | 7007 Old Sauk Rd, Madison, WI 53717-2307 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508406760 | Diana Kay Woodruff | Registered Nurse | Madison West Comprehensive Treatment Center, 151 E. Badger Rd. Suite A, Madison, WI 53713 | 2020-01-15 |
| 1568008886 | Avery Reven Kansteiner | Counselor | 105 Ski Court, Madison, WI 53713 | 2019-11-21 |
| 1518501329 | Erica D Anderson | Counselor | 1125 W Badger Rd Apt 6, Madison, WI 53713 | 2019-11-05 |
| 1942799739 | Emily Natera | Counselor | 128 E. Olin Ave., Ste. 100, Madison, WI 53713 | 2018-05-07 |
| 1295255644 | Renee Denise Wilberg | Counselor | 122 E. Olin Avenue, Madison, WI 53713 | 2017-06-26 |
| 1548793060 | Racquel Williams-kroll | Registered Nurse | 151 East Badger Road Ste A, Madison, WI 53713 | 2017-04-11 |
| 1124570841 | Shirley Norman-johnson | Licensed Practical Nurse | 115 East Badger Rd, Suite A, Madison, WI 53713 | 2016-10-28 |
| 1629525613 | Katherine Simons Melde | Nurse Practitioner | 2222 S Park St Ste 210, Madison, WI 53713 | 2016-09-07 |
| 1013301779 | Bio-medical Applications of Wisconsin, Inc. | Clinic/Center | 2840 Index Rd., Madison, WI 53713 | 2015-03-20 |
| 1902147721 | Jill Zimmerman | Occupational Therapy Assistant | 2801 Coho Street, Suite 300, Madison, WI 53713 | 2013-03-04 |
| Find all providers in zip 53713 | ||||
| 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 |
|---|---|---|---|---|
| 1003457441 | Madison Dentistry LLC | Dentist | 268 Main Street, Suite B, Madison, NJ 07940 | 2019-10-07 |
| 1093154601 | Matthew D Reiland | Dentist | 2921 Landmark Pl Ste 100, Madison, WI 53713-4248 | 2013-06-17 |
| 1720202153 | Stephen Charles Greer II Dmd | Dentist | 401 Baptist Drive, Suite 207, Madison, MS 39110 | 2007-04-13 |
| 1164599460 | David Franklin Butler | Dentist | 505 Cragmont St, Madison, IN 47250-3003 | 2006-11-29 |
| 1598788796 | Mark K Jackson | Dentist | 7007 Old Sauk Road, Madison, WI 53717 | 2006-07-26 |
| 1891727152 | Karen S Ablow | Dentist | 145 Durham Road, Madison, CT 06443 | 2006-07-07 |
| 1851373625 | Jeffrey Scott Brown | Dentist | 106 Highland Way Ste 207, Madison, MS 39110-6930 | 2005-11-17 |
| 1700273208 | North Alabama Oral and Facial Surgery LLC | Dentist | 44 Hughes Rd, Madison, AL 35758-3045 | 2015-04-22 |
| 1174928709 | David F Butler, Dds | Dentist | 505 Cragmont St, Madison, IN 47250-3003 | 2014-10-24 |
| 1346576915 | Madison Oral and Facial Surgery, LLC | Dentist | 44 Hughes Rd, Suite 1500, Madison, AL 35758-2237 | 2009-11-02 |
| Find all providers in MADISON | ||||
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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.