Provider Demographics
NPI:1215666797
Name:AIUPPA, JONATHAN E
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:E
Last Name:AIUPPA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5449 S SUNNY SLOPE RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-8075
Mailing Address - Country:US
Mailing Address - Phone:414-412-8948
Mailing Address - Fax:
Practice Address - Street 1:5500 W BROWN DEER RD STE 100
Practice Address - Street 2:
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53223-2265
Practice Address - Country:US
Practice Address - Phone:414-354-9020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6000018-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice