Wisconsin Dental Group, S.C.
NPI 1104574623ActiveOrganization· Dentist, General Practice· Brookfield, WI
Dentist, General Practice in Brookfield, Wisconsin, registered in NPPES in March 2022, part of Wisconsin Dental Group, S.C. The authorized official on file is Celia Hayes, Credentialing Coordinator.
Overview
| NPI | 1104574623 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Wisconsin Dental Group, S.C. |
| NPI issued | Mar 14, 2022 |
| Last updated in NPPES | Mar 14, 2022 |
| Certified by provider | Mar 14, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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