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General NPI Number Information
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NPI Number | 1629980784
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Entity Type | Individual
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Provider Name | JOAO LUIZ GOMES CARNEIRO MONTEIRO DDS, PHD
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Gender | Male
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 1801 W WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53233-2186
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Country | US
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Telephone | 414-288-6790
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Fax |
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Provider Business Mailing Address
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Address Line | 1795 N WATER ST APT 2629
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City | MILWAUKEE
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State | WI
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Zip | 53202-1626
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Country | US
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Telephone | 857-266-7955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 87861-875
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License Number State | WI
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