DR. TIMOTHY RAYMOND WALL (NPI# 1932255627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932255627 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY RAYMOND WALL |
| Credential | DDS |
| Practice Address |
250 Clark St Pewaukee WI 53072-3529 |
| Practice Telephone | 2626959392 |
| Mailing Telephone | 2626959392 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
3951-015 | WI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659870939 | Timothy Wall | Student in an Organized Health Care Education/Training Program | 128 East Apple St., 2nd Floor, Dayton, OH 45409 | 2018-02-01 |
| 1194938100 | Timothy Jason Wall | Dentist | 4335 College Hills Blvd, San Angelo, TX 76904-6919 | 2007-05-07 |
| 1346263969 | Timothy E Wall | Specialist/Technologist | 1325 San Marco Blvd, #102, Jacksonville, FL 32207-8568 | 2006-07-25 |
| 1841279759 | Timothy Wall | Pediatrics | 636 Raymond Dr, Suite 205, Naperville, IL 60563-9789 | 2006-01-10 |
| Street Address |
250 CLARK ST |
| City | PEWAUKEE |
| State | WI |
| Zip Code | 53072-3529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740805423 | Froedtert Health Neighborhood Hospital, LLC | General Acute Care Hospital | 209 Pewaukee Rd, Pewaukee, WI 53072 | 2020-06-09 |
| 1871122556 | Mary Kofigah | Nurse Practitioner | 21150 W. Capital Dr., Brookfield, WI 53072 | 2020-04-05 |
| 1609436559 | Brianna Kelly Bates | Optometrist | 1440 Capitol Drive, Suite B, Pewaukee, WI 53072 | 2019-06-13 |
| 1932767316 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1440 Capital Drive, Suite B, Pewaukee, WI 53072 | 2019-05-31 |
| 1417426925 | Edward Dow | Psychologist | W268n1988 Shooting Star Road, Pewaukee, WI 53072 | 2018-11-14 |
| 1346664869 | Jane Sweney | Counselor | 325 Forest Grove Drive, Pewaukee, WI 53072 | 2014-02-05 |
| 1093082182 | Kristin Elizabeth Thieneman | Pharmacist | 443 Pewaukee Road, Pewaukee, WI 53072 | 2011-11-17 |
| 1922318393 | Ariane Machin | Psychologist | 161 W. Wisconsin Ave #2b, Pewaukee, WI 53072 | 2010-10-19 |
| 1083930879 | Scott Robert Borkenhagen | Student in an Organized Health Care Education/Training Program | 384 Willow Grove Dr., Unit D, Pewaukee, WI 53072 | 2010-04-19 |
| 1912174988 | Robert Thomas Lynch | Dentist | 234 Oakton Ave, Pewaukee, WI 53072 | 2008-05-09 |
| Find all providers in zip 53072 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912174988 | Robert Thomas Lynch | Dentist | 234 Oakton Ave, Pewaukee, WI 53072 | 2008-05-09 |
| 1679694905 | Bryan Schwartz | Dentist | 125 W Wisconsin Ave, Suite 102, Pewaukee, WI 53072-3416 | 2007-04-03 |
| 1477673556 | Healthy Smiles Dental Care, S.c. | Dentist | 285 Forest Grove Dr, Suite 201, Pewaukee, WI 53072-3782 | 2007-03-30 |
| 1740368737 | Gina Foti Ostrand | Dentist | 617 Ryan St, Pewaukee, WI 53072-1844 | 2006-11-01 |
| 1164436614 | Jeffrey Stuart Niedziela | Dentist | 135 Capitol Dr, Pewaukee, WI 53072-2401 | 2006-07-28 |
| 1487697579 | John Paul Stockinger | Dentist | 131 E Wisconsin Ave, Pewaukee, WI 53072-3471 | 2006-06-14 |
| 1184672065 | Christy Anna Gajewski | Dentist | 2305 Silvernail Rd, Pewaukee, WI 53072-5402 | 2006-05-04 |
| 1538787650 | Christine Marie Fischer | Dentist | N35w23770 Capitol Dr, Pewaukee, WI 53072-6312 | 2020-07-07 |
| 1154812881 | Richard Razdolsky | Dentist | 135 Capitol Dr, Pewaukee, WI 53072-2401 | 2018-05-29 |
| 1144603671 | Mark R Zelko | Dentist | 2305 Silvernail Rd, Pewaukee, WI 53072-5402 | 2015-07-01 |
| Find all providers in PEWAUKEE | ||||
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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.