Healthcare Provider Details

I. General information

NPI: 1265451744
Provider Name (Legal Business Name): GEORGE EUGENE ROONEY JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11711 W BURLEIGH ST
WAUWATOSA WI
53222-3108
US

IV. Provider business mailing address

18230 LE CHATEAU DR
BROOKFIELD WI
53045-4922
US

V. Phone/Fax

Practice location:
  • Phone: 414-771-2345
  • Fax:
Mailing address:
  • Phone: 262-786-7959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number5000-942-015
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: