GREATER MILWAUKEE ORAL SURGERY, L.L.C. (NPI# 1720569783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720569783 |
| Entity Type | Organization |
| Organization Name | GREATER MILWAUKEE ORAL SURGERY, L.L.C. |
| Practice Address |
4811 S 76th St Ste 304 Greenfield WI 53220-4350 |
| Practice Telephone | 4142813344 |
| Practice Fax Number | 4142811080 |
| Mailing Telephone | 4142813344 |
| Mailing Fax Number | 4142811080 |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |
| Authorized Official Name | DR. ROB GOECKERMANN (OWNER) |
| Authorized Official Telephone | 4142813344 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5910-15 | WI | Dental Providers |
| Street Address |
4811 S 76TH ST STE 304 |
| City | GREENFIELD |
| State | WI |
| Zip Code | 53220-4350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871061069 | Kathleen Elizabeth White | Orthotist | 6790 W. Layton Ave, Greenfield, WI 53220 | 2018-11-06 |
| 1992284087 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 4859 South 60th Street, Greenfield, WI 53220 | 2018-08-09 |
| 1609394220 | Aaron Park | Speech-Language Pathologist | 3540 S. 43rd St., Milwaukee, WI 53220 | 2017-09-04 |
| 1730601675 | Rosaana Avila | Physical Therapist | 3944 S. 60th St., Milwaukee, WI 53220 | 2017-07-12 |
| 1285002667 | Casey E Reis | Nurse Practitioner | 4848 S. 76th Street, Greenfield, WI 53220 | 2015-09-02 |
| 1437539798 | Luke Robert Garceau | Physical Therapist | 6520 W. Layton Ave #101, Greenfield, WI 53220 | 2015-06-02 |
| 1295139012 | Tammy Giannopoulos, LLC | Clinic/Center | 4402 S 68th St Suite 100, Greenfield, WI 53220 | 2014-10-22 |
| 1861754244 | Lakeshore Medical Clinic | Occupational Therapist | 4444 West Loomis Road, 200, Greenfield, WI 53220 | 2012-06-12 |
| 1598083115 | Rebecca Anne Kappes | Licensed Practical Nurse | 8208 W Tripoli, Milwaukee, WI 53220 | 2010-05-06 |
| 1699941005 | Susan Marie Delaet | Physical Therapy Assistant | 5700 West Layton Ave, Greenfield, WI 53220 | 2008-05-06 |
| Find all providers in zip 53220 | ||||
| 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 |
|---|---|---|---|---|
| 1710964028 | Christopher Andrew Blount | Dentist | 285 High St, Greenfield, MA 01301-2608 | 2005-12-28 |
| 1356504096 | Robert Goeckermann | Dentist | 4811 S 76th St, Suite 304, Greenfield, WI 53220-4364 | 2008-07-02 |
| 1790963353 | Wendy Marie Pietz | Dentist | 3033 W Layton Ave, Suite 103, Greenfield, WI 53221-2628 | 2008-02-06 |
| 1235251125 | Wendy M Pietz, Dds, Sc | Dentist | 4600 W Loomis Rd, Suite 220, Greenfield, WI 53220-4858 | 2007-04-04 |
| 1285649921 | Oral & Maxillofacial Surgery Consultants of Wisconsin, S.c. | Dentist | 4811 S 76th St, Suite 304, Greenfield, WI 53220-4364 | 2006-07-30 |
| 1992719280 | Ronald Henry Nellen | Dentist | 4811 S 76th St, Suite 304, Greenfield, WI 53220-4364 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1003100470 | Eddie Kiyoshi Brotkowski | Dentist | 464 S Hickory St Ste A, Fond Du Lac, WI 54935-5531 | 2011-06-02 |
| Find all providers with the same taxonomy | ||||
| City | GREENFIELD |
| Zip Code | 53220 |
Please comment or provide details below to improve the information on GREATER MILWAUKEE ORAL SURGERY, L.L.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.