Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Wisconsin Dental Group, SC

Organization Pediatric Dentistry · NPI 1265562631

Wisconsin Dental Group, SC is a Pediatric Dentistry in Glendale, Wisconsin. Registered with an NPI since 2007.

In the registry since
2007
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Practice location Address checks out

7040 N Port Washington Rd Ste 414
Glendale, WI 53217-3885
Phone: (920) 212-4641
Fax: (920) 954-9080
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X

Record details

NPI number1265562631
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationWisconsin Dental Group, SC
Authorized official Celia Hayes — Credentialing Coordinator · (217) 540-2100
Other names Forwarddental Glendale
NPI enumeratedMarch 6, 2007
Last updated in NPPESApril 15, 2022
Certification dateApril 15, 2022
Mailing address7040 N Port Washington Rd Ste 414, Glendale, WI 53217-3885