WISCONSIN DENTAL GROUP, S.C. (NPI# 1184754459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184754459 |
| Entity Type | Organization |
| Organization Name | WISCONSIN DENTAL GROUP, S.C. |
| Other Organization Name | FORWARD DENTAL |
| Practice Address |
6217 S Packard Ave Cudahy WI 53110-3096 |
| Practice Telephone | 4147645570 |
| Mailing Telephone | 4147645570 |
| 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 |
6217 S PACKARD AVE |
| City | CUDAHY |
| State | WI |
| Zip Code | 53110-3096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164496477 | Cudahy Dental Associates, S.c. | Dentist | 6217 S Packard Ave, Cudahy, WI 53110-3096 | 2006-02-14 |
| 1912565227 | David Lubin | Dentist | 6217 S Packard Ave, Cudahy, WI 53110-3096 | 2019-06-01 |
| 1043786601 | Karen Wang | Dentist | 6217 S Packard Ave, Cudahy, WI 53110-3096 | 2018-10-22 |
| 1861847097 | Kimberly Carmichael | Dentist | 6217 S Packard Ave, Cudahy, WI 53110-3096 | 2016-04-25 |
| 1760820567 | Susan Angel Meinerz | Dentist | 6217 S Packard Ave, Cudahy, WI 53110-3096 | 2013-06-13 |
| 1649618497 | Michael Louis Jumes | Dentist | 6217 S Packard Ave, Cudahy, WI 53110-3096 | 2013-06-13 |
| 1164717732 | Frank A Caputo | Dentist | 6217 S Packard Ave, Cudahy, WI 53110-3089 | 2011-06-12 |
| 1003136953 | Anne M Allmann | Dentist | 6217 S Packard Ave, Cudahy, WI 53110-3089 | 2010-06-02 |
| 1578537643 | Michael J Ketten | Dentist | 6217 S Packard Ave, Cudahy, WI 53110-3096 | 2006-02-15 |
| 1275507345 | John S Grant | Dentist | 6217 S Packard Ave, Cudahy, WI 53110-3096 | 2006-02-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164059150 | Access Mobility Vans, Inc. | Durable Medical Equipment & Medical Supplies | 1995 E. Norse Ave., Cudahy, WI 53110 | 2020-03-27 |
| 1497191357 | Kristel Roebbeke | Occupational Therapist | 4157 W College Ave, Milwaukee, WI 53110 | 2013-05-20 |
| 1568684058 | City of Cudahy | Case Management | 5050 South Lake Drive, Cudahy, WI 53110 | 2007-05-03 |
| 1104854363 | Mathew George Mathai | Internal Medicine | 5900 S. Lake Dr., Cudahy, WI 53110 | 2006-06-28 |
| 1174917199 | Alyssa Kaleta | Internal Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2015-03-27 |
| 1740546829 | Fatima Ali | Family Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2012-04-03 |
| 1609003508 | Elizabeth A Vissat | Podiatrist | 5900 S Lake Dr, 2 West, Cudahy, WI 53110 | 2009-06-18 |
| 1366616864 | Miguel A Aguilera | Anesthesiology | 5900 S Lake Dr, Cudahy, WI 53110 | 2008-04-15 |
| 1235355983 | Aurora Health Care Metro, Inc. | Clinic/Center | 5900 S Lake Drive, Cudahy, WI 53110 | 2007-04-18 |
| 1114005618 | Manila Sodhi | Internal Medicine | 5900 S Lake Dr, 2 West, Cudahy, WI 53110 | 2006-11-01 |
| Find all providers in zip 53110 | ||||
| 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 |
|---|---|---|---|---|
| 1558768358 | Behrooz Zinati Dds Inc | Dentist | 7607 Atlantic Ave., Cudahy, CA 90201 | 2014-11-24 |
| 1124333273 | Kittleson & Kittleson, S.c. | Dentist | 3527 E Squire Ave, Cudahy, WI 53110-1426 | 2010-08-13 |
| 1639551278 | Deerwood Orthodontics, LLC | Dentist | 3527 E Squire Ave, Cudahy, WI 53110-1426 | 2015-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407488075 | Kristo Ltd | Dentist | 440 Chestnut St # 100, Wisconsin Rapids, WI 54494-4807 | 2020-02-11 |
| 1578104006 | Daniela Amaya Fuenmayor | Dentist | 11011 W North Ave Apt 367, Wauwatosa, WI 53226-2271 | 2019-10-07 |
| 1295382992 | Noble Orthodontics, LLC | Dentist | 109 N Dodge St, Burlington, WI 53105-1918 | 2019-08-19 |
| 1295391472 | Christine Lowdon Triggs | Dentist | 21680 West Bluemound Rd, Waukesha, WI 53186 | 2019-05-14 |
| 1811498561 | Orthodontic Specialists of Onalaska and The Coulee Region | Dentist | 2747 National Dr, Onalaska, WI 54650-8784 | 2018-02-27 |
| 1508247198 | Lauren Evan Montoure Teske | Dentist | 2000 Shady Ln, Green Bay, WI 54313-9311 | 2015-06-09 |
| 1588042154 | Bubon & Associates, Orthodontics, Sc | Dentist | 4950 S 27th St, Milwaukee, WI 53221-2606 | 2015-05-14 |
| 1235517897 | 1bubon & Associates, Orthodontics, Sc | Dentist | 1701 N Mayfair Rd, Suite C, Wauwatosa, WI 53226-3046 | 2015-05-14 |
| 1851779417 | Bubon & Associates, Orthodontics, Sc | Dentist | W188s7830 Racine Ave, Suite 300, Muskego, WI 53150-8290 | 2015-05-14 |
| 1578941548 | Bubon & Associates, Orthodontics, Sc | Dentist | N4w21680 Bluemound Rd, Waukesha, WI 53186-2943 | 2015-05-11 |
| Find all providers with the same taxonomy | ||||
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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.