Dental Specialists of Milwaukee LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

DENTAL SPECIALISTS OF MILWAUKEE LLC

Practice address

8405 W Forest Home Ave
Greenfield, WI 53228-3407

Phone

(414) 425-7710

NPI assigned

Oct 3, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kelsey Shingo Tengan, DDS, MS

Title

Periodontist, Partner

Phone

(808) 283-1817

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1013482298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8405 W FOREST HOME AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283407",
            "telephone_number": "414-425-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8405 W FOREST HOME AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283407",
            "telephone_number": "414-425-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALISTS OF MILWAUKEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "TENGAN",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_middle_name": "SHINGO",
        "authorized_official_title_or_position": "PERIODONTIST, PARTNER",
        "authorized_official_telephone_number": "808-283-1817",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Marie Delaet, PTA
• Alina Delgado
• Mary Lynn Deli, APNP
• Nicole Delio
• Dental 360 Greenfield LLC
• Amanda Marie Derewicz, LCSW
• Dermatologic Surgery Associates
• Jacqueline Deroach, PT
• Suzanne Derosier
• Angela Rae Derouin, MS, CCC-SLP

• Periodontics in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Periodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.