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WISCONSIN DENTAL GROUP S.C. NPI 1265562631


NPI Information

NPI: 1265562631
Provider Name: WISCONSIN DENTAL GROUP, S.C.

Doing Business As: FORWARDDENTAL GLENDALE

Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
7040 N PORT WASHINGTON RD STE 414
GLENDALE, WI
ZIP 53217
Phone: (920) 212-4641
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WISCONSIN DENTAL GROUP, S.C. is a pediatric dentistry dentist in Glendale, WI. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. WISCONSIN DENTAL GROUP, S.C. NPI is 1265562631. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Forwarddental Glendale.

The provider's business location address is:

7040 N PORT WASHINGTON RD STE 414
GLENDALE, WI
ZIP 53217-885
Phone: (920) 212-4641
Fax: (920) 954-9080

The provider's authorized official is Celia Hayes .
The authorized official title is Credentialing Coordinator and has the following contact phone number (217) 540-2100.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 4/15/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0221XDentistPediatric DentistryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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