OrganizationActive
Edp of Wisconsin, Sc
NPI 1639685779 · Dental Clinic/Center · Hartland, WI
Provider details
- NPI number
- 1639685779
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Melissa Garibay, Credentialing Manager(312) 736-8963
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
10 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
600 Hartbrook Dr Stop 7
Hartland, WI 53029-1436
Phone: (262) 367-0680
Street-level locationGet directions
Mailing address
141 W Jackson Blvd Ste 210
Chicago, IL 60604-3048
Additional practice locations (9)
- 141 W Jackson Blvd Ste 210Chicago, IL 60604-3048Phone: (312) 736-8963
- 17160 W North Ave Ste 101Brookfield, WI 53005-4437Phone: (262) 782-1655
- 7020 N Port Washington Rd Ste 216Glendale, WI 53217-3800Phone: (414) 964-0680
- 302 S Pine StGrantsburg, WI 54840-7930Phone: (715) 463-2882
- 6121 7th AveKenosha, WI 53143-4506Phone: (262) 654-6535
- 1825 N Martin Luther King DrMilwaukee, WI 53212-3673Phone: (414) 372-7374
- 655 Deerwood AveNeenah, WI 54956-1629Phone: (920) 727-9595
- 820 Summit AveOconomowoc, WI 53066-3973Phone: (262) 567-4466
- 7425 Main St WWebster, WI 54893-8207Phone: (715) 866-4204
Registry dates
- Enumerated
- 2017-12-27
- Last updated
- 2021-09-14
- Certified
- 2021-09-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.