MDC MILWAUKEE, LLC


Address: 4701 W National Ave, Milwaukee, WI 53214-3521
Phone: 9205793188

MDC MILWAUKEE, LLC (NPI# 1679116685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679116685
Entity Type Organization
Organization Name MDC MILWAUKEE, LLC
Practice Address 4701 W National Ave
Milwaukee
WI 53214-3521
Mailing Address Po Box 1658
Fond Du Lac
WI 54936-1658
Practice Telephone 9205793188
Mailing Telephone 9205793188
Enumeration Date 2019-10-22
Last Update Date 2019-10-22
Authorized Official Name MR. BERNARD JOSEPH BOLKA IV (CFO)
Authorized Official Telephone 9205793188
Authorized Official Credential CPA
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Funke Family Dentistry Doing Business As Name - Organization

Office Location

Street Address 4701 W NATIONAL AVE
City MILWAUKEE
State WI
Zip Code 53214-3521

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1740740208 Melanie Figueroa Counselor West Milwaukee Ctc, 1610 Miller Park Way, West Milwaukee, WI 53214 2019-03-21
1619403011 Lea Salome Denny Counselor 8626b W Greenfield Ave, Suite B300, West Allis, WI 53214 2017-05-04
1891148318 West Allis Prescription Center Inc Pharmacy 6737 W Washington Ave, Suite 1100, West Allis, WI 53214 2016-07-20
1316390495 Kristina Overlee Nurse Practitioner 6737 W. Washington Street, Suite 2150, West Allis, WI 53214 2016-07-13
1801239843 Daniel Anthony Cichy Pharmacist 10101 W Greenfield Ave Ste 130, West Allis, WI 53214 2013-04-09
1295072544 Wisconsin Vision, Inc. Optometrist 1220 Miller Park Way, West Milwaukee, WI 53214 2013-01-07
1831457720 Kevin Konieczka Physical Therapist 1224 Miller Parkway, Milwaukee, WI 53214 2012-04-27
1497031843 Jill Elizabeth Gerou Registered Nurse 8420 West Greenfield Ave, Apartment #7, West Allis, WI 53214 2011-10-31
1700176815 Carolyn Hasek Counselor 1126 S 70th St Ste 112-113, West Allis, WI 53214 2011-04-10
1972802775 Barbara Smith Licensed Practical Nurse 651 S 63 St, Apt1, Milwaukee, WI 53214 2011-03-18
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Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073135331 Oasis Dental LLC Clinic/Center 1037 S Cesar E Chavez Dr, Milwaukee, WI 53204-2204 2020-05-09
1598040263 Renita C Burrell, Dds, Ms, S.c. Clinic/Center 2457 N Mayfair Rd Ste 102, Milwaukee, WI 53226-1405 2011-10-13
1487811188 Marion Family Dental Clinic Clinic/Center 4302 N 76th Street, Milwaukee, WI 53222 2008-05-20
1063622561 Stanley I. Sehler D.d.s, S.c Clinic/Center 2300 N Mayfair Rd Ste 705, Milwaukee, WI 53226-1533 2007-05-23
1215074604 American Dental Professional Services, LLC Clinic/Center 9054 N Deerbrook Trl, Milwaukee, WI 53223-2474 2007-02-01
1730184557 Northridge Dental Center S.c. Clinic/Center 7906 N 76th St, Milwaukee, WI 53223-3916 2005-06-17
1437152493 Burleigh Dental, Sc Clinic/Center 7623 W Burleigh St, Milwaukee, WI 53222-5001 2005-05-24
1467059865 Wisconsin Smiles Clinic/Center 6719 W Capitol Dr, Milwaukee, WI 53216-2041 2020-10-08
1164047130 Mequon Deer Dental, LLC Clinic/Center 7400 W Brown Deer Rd, Milwaukee, WI 53223-2078 2020-06-15
1184279028 Lake Park Dental LLC Clinic/Center 2524 E Webster Pl Ste 201, Milwaukee, WI 53211-4257 2019-08-07
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Competitor

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City MILWAUKEE
Zip Code 53214

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Dataset Information

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.

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