DR. GEOFFREY L. MYKLEBY (NPI# 1518011485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1518011485 |
Entity Type | Individual |
Full Name | DR. GEOFFREY L. MYKLEBY |
Credential | DENTISTRY |
Practice Address |
8700 W Watertown Plank Rd Ste 11 Wauwatosa WI 53226-3595 |
Mailing Address |
8700 W Watertown Plank Rd Suite 11 Milwaukee WI 53226-3595 |
Practice Telephone | 4144530445 |
Practice Fax Number | 4144531589 |
Mailing Telephone | 4144530445 |
Mailing Fax Number | 4144531589 |
Enumeration Date | 2007-01-22 |
Last Update Date | 2016-03-31 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
2409 | WI | Dental Providers |
Street Address |
8700 W WATERTOWN PLANK RD STE 11 |
City | WAUWATOSA |
State | WI |
Zip Code | 53226-3595 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
Find all providers in zip 53226 |
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 |
---|---|---|---|---|
1588131163 | Shiloh Joshua Golden | Dentist | 10625 W North Ave Ste 320, Wauwatosa, WI 53226-2315 | 2018-10-31 |
1699205336 | Patrick T Clancy | Dentist | 11904 W North Ave Ste 105, Wauwatosa, WI 53226-2062 | 2017-06-15 |
1396190476 | Katharine Nelson Suwalski | Dentist | 7626 Warren Ave, Wauwatosa, WI 53213-2258 | 2016-04-26 |
1538360086 | Leonard R. Machi | Dentist | 12217 W North Ave, Wauwatosa, WI 53226-2056 | 2007-05-31 |
1073725586 | John R Wussow | Dentist | 10225 W. Capitol Dr, Wauwatosa, WI 53222 | 2007-05-04 |
1508084245 | John L Scheels | Dentist | 6803 W Wells St, Wauwatosa, WI 53213-3811 | 2007-04-20 |
1447375431 | Timothy Richard Kirkpatrick | Dentist | 11040 W Bluemound Rd, Suite 201, Wauwatosa, WI 53226 | 2007-03-20 |
1316004864 | Robin Ann Gorman | Dentist | 6101 W Vliet St, Suite 101, Wauwatosa, WI 53213-2485 | 2007-01-03 |
1376608257 | Tom Tongas | Dentist | 2380 N 124th St, Wauwatosa, WI 53226-1071 | 2006-12-22 |
1679631550 | David G Lloyd | Dentist | 10425 W North Ave Ste 236, Wauwatosa, WI 53226-2416 | 2006-12-05 |
Find all providers in WAUWATOSA |
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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.