Wisconsin Dental Group, S.C.
Dentist, General Practice in Oconomowoc, WI. Organization (NPI-2).
Details
- NPI
- 1013665561
- Entity type
- Organization (NPI-2)
- Legal business name
- Wisconsin Dental Group, S.C.
- Organization subpart
- Yes
- Enumeration date
- Mar 14, 2022
- Certification date
- Mar 14, 2022
- Last updated
- Mar 14, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Forwarddental Oconomowoc (Doing Business As)
Practice location
1320 Pabst Farms Cir Unit 190Oconomowoc, WI 53066-4877
Phone 262-244-0288 · Fax 262-244-0290
Mailing address
1320 Pabst Farms Cir Unit 190Oconomowoc, WI 53066-4877
Phone 262-244-0288 · Fax 262-244-0290
Authorized official
Celia Hayes
Credentialing Coordinator
2175402100
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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