ROBERT A. WALLOCK (NPI# 1952599573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952599573 |
| Entity Type | Individual |
| Full Name | ROBERT A. WALLOCK |
| Practice Address |
12720 W North Ave Brookfield WI 53005-4637 |
| Practice Telephone | 2627840053 |
| Mailing Telephone | 2627840053 |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2016-11-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
4138-015 | WI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TYPE 2 NPI | 1366586224 | 01 |
| Street Address |
12720 W NORTH AVE |
| City | BROOKFIELD |
| State | WI |
| Zip Code | 53005-4637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710094719 | Kim Tran Wertz | Dentist | 12720 W North Ave, Bldg B, Brookfield, WI 53005 | 2006-08-24 |
| 1760882138 | Amy Morgan-tautges | Social Worker | 12720 W North Ave, Building B - Suite 200, Brookfield, WI 53005 | 2014-09-03 |
| 1578989810 | Erin Rachwal | Social Worker | 12720 W North Ave, Suite B-200, Brookfield, WI 53005-4637 | 2014-03-11 |
| 1508287780 | Lisa Ann Johnson | Counselor | 12720 W North Ave, Brookfield, WI 53005-4637 | 2013-12-14 |
| 1053740506 | Erin Rinderle | Social Worker | 12720 W North Ave, Building B, Suite 200, Brookfield, WI 53005-4637 | 2013-11-05 |
| 1942508965 | Jessica Lange | Counselor | 12720 W North Ave, Building B Suite 200, Brookfield, WI 53005-4637 | 2011-03-01 |
| 1801198858 | Kim Tran-wertz Dds Ms LLC | Dentist | 12720 W North Ave, Brookfield, WI 53005-4637 | 2010-11-24 |
| 1952569105 | Arger Chris Markakis | Dentist | 12720 W North Ave, Brookfield, WI 53005-4637 | 2008-05-23 |
| 1326255597 | Edward W. Hoffmann | Dentist | 12720 W North Ave, Brookfield, WI 53005-4637 | 2007-05-17 |
| 1366586224 | Elmbrook Oral & Maxillofacial Surgery Assoc., S.c. | Dentist | 12720 W North Ave, Brookfield, WI 53005-4637 | 2007-02-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154937621 | Nsk Precision Healing & Wellness | Acupuncturist | 17040 W. Greenfield Ave #6, Brookfield, WI 53005 | 2020-09-21 |
| 1033772124 | Dbt Consultants LLC | Social Worker | 200 S. Executive Drive, Ste. 101, Brookfield, WI 53005 | 2019-04-15 |
| 1780142588 | Ashley Wing | Registered Nurse | 405 Bishops Way, Apt 555, Brookfield, WI 53005 | 2019-03-11 |
| 1407370398 | Tombolo, LLC | Clinic/Center | 12545 W. Burleigh Rd., Suite 10, Brookfield, WI 53005 | 2017-08-01 |
| 1720509045 | Rss William Conner LLC | Dentist | 15455 W Bluemound Rd Ste 250, Brookfield, WI 53005 | 2017-06-28 |
| 1669926598 | Mackenzie Rondeau | Physical Therapist | 1905 N Calhoun Rd Ste 105, Brookfield, WI 53005 | 2016-08-09 |
| 1699159319 | Charles Alan Kass | Dentist | 12720 W. North Avenue, Brookfield, WI 53005 | 2015-07-13 |
| 1164804274 | Mary-catherine Nimphius | Counselor | 250 S. Sunny Slope Rd, #128, Brookfield, WI 53005 | 2015-06-25 |
| 1528447034 | Weighless Md, LLC | Dietitian, Registered | 14960 W. Greenfield Ave Suite 104, Brookfield, WI 53005 | 2015-05-29 |
| 1366837346 | Maegan Michelle Cook | Dentist | 13780 W Greenfield Ave Ste 780, Brookfield, WI 53005 | 2015-04-06 |
| Find all providers in zip 53005 | ||||
| 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 |
|---|---|---|---|---|
| 1366586224 | Elmbrook Oral & Maxillofacial Surgery Assoc., S.c. | Dentist | 12720 W North Ave, Brookfield, WI 53005-4637 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720569783 | Greater Milwaukee Oral Surgery, L.L.C. | Dentist | 4811 S 76th St Ste 304, Greenfield, WI 53220-4350 | 2018-08-27 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | BROOKFIELD |
| Zip Code | 53005 |
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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.