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PRO DENTAL WI 1 PC
NPI 1013744523
Dentist in Milwaukee, WI

Active since September 18, 2024
1838 S 15TH ST, MILWAUKEE, WI 53204(414) 455-8805(414) 455-8812 Get Directions Write a Review

NPPES record last updated: September 18, 2024. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Pro Dental Wi 1 Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRO DENTAL WI 1 PC (NPI 1013744523), doing business as Destiny Dental Of Milwaukee, is a healthcare organization registered as a dentist in Milwaukee, Wisconsin and active in the NPI registry since September 2024. The organization lists Simone Wilson-adeleke, Director Of Credentialing, as its authorized official.

NPPES Registry Identity

NPI1013744523
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NamePRO DENTAL WI 1 PC
Location Address1838 S 15TH STMilwaukee, WI 53204-3225
Mailing Address10 Woodbridge Center Dr Ste 520Woodbridge, NJ 07095-1152 · (732) 731-8398
Phone(414) 455-8805
Fax(414) 455-8812
Organization SubpartNo
Authorized OfficialSimone Wilson-adelekeDirector Of Credentialing · (732) 731-8398
Enumeration DateSeptember 18, 2024
NPPES CertifiedSeptember 18, 2024
✔ NPI 1013744523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Also ListedDentist · General PracticeTaxonomy 1223G0001X
1838 S 15TH ST, Milwaukee, WI 53204
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Other Names 1

Doing Business AsDestiny Dental Of Milwaukee

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SRITA CHUNDRU
Dentist
1838 S 15TH ST
MILWAUKEE, WI 53204
Milwaukee County (201) 889-7383
D2 DENTAL OF WISCONSIN, S.C.
Dentist (General Practice)
1838 S 15TH ST
MILWAUKEE, WI 53204
Milwaukee County (414) 455-8805

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pro Dental Wi 1 PC's NPI number?

The NPI number for Pro Dental Wi 1 PC is 1013744523. It was assigned to this organization in the NPPES registry on September 18, 2024. The provider is doing business as Destiny Dental of Milwaukee.

Where is Pro Dental Wi 1 PC located?

Pro Dental Wi 1 PC is located at 1838 S 15th St, Milwaukee, WI 53204. The listed phone number is (414) 455-8805.

What is Pro Dental Wi 1 PC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Pro Dental Wi 1 PC was last updated on September 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.